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Section I - Introduction, General Instructions, and Advisories (11/28/2017) Page 1 of 6 I.A. Introduction/General Instructions Each wireless communication facility is authorized through a Conditional Use Permit, which is a discretionary entitlement that may be granted proceeding review of this application and technical reports. Depending on the size of the wireless communication facility, either the Planning Director or Planning Commission will review the Staff Report prepared based on information contained herein, and make the necessary findings to either approve, approve with modifications and conditions, or deny the permit request. The duration of a Conditional Use Permit for a wireless communication facility is no longer than ten (10) years. This application should not be used for any of the following: o Routine Maintenance 1 o Zoning Clearance o Section 6409(a) Zoning Clearance o Permit Adjustment The information and materials 2 requested in this application packet may be required by County staff in order to: (a) deem your application complete, thus allowing for the preparation of an Initial Study and a determination as to the type of environmental document that is required for your project; 3 (b) assess your project’s consistency with the rules and regulations that apply to the discretionary entitlement(s) for wireless communication facilities; and, (c) process your application as quickly as possible. 4 Although all of the questions and informational requests in this application packet might not apply to your project, carefully review these documents in their entirety to ensure that you provide the requisite information and materials for your application. In addition, please be advised that: 1 Routine maintenance is work performed by the operator to restore a facility to its permitted condition, including the restoration or replacement of existing faux design elements, antennas, and equipment in equipment cabinets. In all cases, the replacement of antennas or faux design elements shall be limited to reproductions of the originally permitted equipment. Routine maintenance also includes testing and repair of operational features which do not alter the physical dimensions of the permitted wireless communication facility - such as backup generators, fire suppression systems, air ventilation systems, and cable modifications in cable conduits. 3 County of Ventura County Administrative Supplement to the State CEQA Guidelines (Last Amended August 3, 1999, §5.1), Ventura County Initial Study Assessment Guidelines (February 2006), and the State CEQA Guidelines [California Code of Regulations, Title 14, Chapter 3, §15063). 4 For a discussion of, as well as the policies, ordinances, and regulations related to, the discretionary entitlement, subdivision, and legislative action process, please see the following website: https://www.vcrma.org/discretionary-approvals. For a discussion of, as well as the policies, ordinances, and regulations related to, the environmental review process, please see the following website: https://www.vcrma.org/ceqa-implementation-and-initial-study-assessment-guidelines All permit processing and outstanding fees must be paid in full at the time at which you submit your application 5 5 For information on the fees that are required to process your application, please see the following website: https://www.vcrma.org/planning-permit-fees 2 With the exception of headings and titles, fees and supplemental materials that are required with your application are indicated in bold font and are listed in the "Summary of Documents Required" list located at the end of this packet. 805 654-2488 www.vcrma.org/divisions/planning

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Page 1: I.A. Introduction/General Instructions...Section I - Introduction, General Instructions, and Advisories (11/28/2017) Page 1 of 6 I.A. Introduction/General Instructions Each wireless

Section I - Introduction, General Instructions, and Advisories (11/28/2017) Page 1 of 6

I.A. Introduction/General Instructions

Each wireless communication facility is authorized through a Conditional Use Permit, which is a discretionary entitlement that may be granted proceeding review of this application and technical reports. Depending on the size of the wireless communication facility, either the Planning Director or Planning Commission will review the Staff Report prepared based on information contained herein, and make the necessary findings to either approve, approve with modifications and conditions, or deny the permit request. The duration of a Conditional Use Permit for a wireless communication facility is no longer than ten (10) years. This application should not be used for any of the following:

o Routine Maintenance1

o Zoning Clearanceo Section 6409(a) Zoning Clearanceo Permit Adjustment

The information and materials2 requested in this application packet may be required by County staff in order to: (a) deem your application complete, thus allowing for the preparation of an Initial Study and a determination as to the type of environmental document that is required for your project;3 (b) assess your project’s consistency with the rules and regulations that apply to the discretionary entitlement(s) for wireless communication facilities; and, (c) process your application as quickly as possible.4 Although all of the questions and informational requests in this application packet might not apply to your project, carefully review these documents in their entirety to ensure that you provide the requisite information and materials for your application. In addition, please be advised that:

1 Routine maintenance is work performed by the operator to restore a facility to its permitted condition, including the restoration or replacement of existing faux design elements, antennas, and equipment in equipment cabinets. In all cases, the replacement of antennas or faux design elements shall be limited to reproductions of the originally permitted equipment. Routine maintenance also includes testing and repair of operational features which do not alter the physical dimensions of the permitted wireless communication facility - such as backup generators, fire suppression systems, air ventilation systems, and cable modifications in cable conduits.

3 County of Ventura County Administrative Supplement to the State CEQA Guidelines (Last Amended August 3, 1999, §5.1), Ventura County Initial Study Assessment Guidelines (February 2006), and the State CEQA Guidelines [California Code of Regulations, Title 14, Chapter 3, §15063). 4 For a discussion of, as well as the policies, ordinances, and regulations related to, the discretionary entitlement, subdivision, and legislative action process, please see the following website: https://www.vcrma.org/discretionary-approvals. For a discussion of, as well as the policies, ordinances, and regulations related to, the environmental review process, please see the following website: https://www.vcrma.org/ceqa-implementation-and-initial-study-assessment-guidelines

• All permit processing and outstanding fees must be paid in full at the time at which yousubmit your application5

5 For information on the fees that are required to process your application, please see the following website:

https://www.vcrma.org/planning-permit-fees

2 With the exception of headings and titles, fees and supplemental materials that are required with your application are indicated in bold font and are listed in the "Summary of Documents Required" list located at the end of this packet.

805 654-2488 www.vcrma.org/divisions/planning

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• One original and one copy of a “Fee Reimbursement Agreement” must be completed,signed by the property owner(s), and submitted with all applications,

• All required information must be submitted as part of a single submission; partial submissionswill result in the return of your application packet, and

• The applicant is expected to have reviewed applicable policies and regulations pertaining towireless communication facilities, including the Ventura County General Plan Goals Policiesand Programs (GPP), Ventura County Non-Coastal Zoning Ordinance (NCZO) and theVenturaCounty Coastal Zoning Ordinance (CZO).

This application packet includes required materials, as well as instructions on where to obtain and how to prepare, supplemental materials that are needed to file an application for a discretionary entitlement for wireless communications facilities. This application packet includes:

• “Section II -- Discretionary Entitlement for Wireless Communication Facility Checklist ofRequirements.”

• “Section III -- Discretionary Entitlement Wireless Communication Facility ApplicationQuestionnaire.” which identifies supplemental technical reports, studies, and information thatmust be submitted as part of your application. Please be aware that any missing informationwill result in a determination that your application is inadequate and all materials will bereturned to you. County staff will begin processing your application when your applicationincludes all of the materials and information that are required, as determined by the PlanningDivision’s Permit Coordinator;

• “Fee Reimbursement Agreement” form (included in Section III); and,• “Certification Statement of Hazardous Waste/Substance Site” form (included in Section III).

Please be advised that submitting these materials does not guarantee that your application will be deemed technically adequate and satisfactory pursuant to all applicable Federal, state, and local development standards and codes. County agencies still must conduct technical reviews of your reports, plans, and application materials and will inform you if any required information is missing or inadequate. Missing or inadequate technical information about your project can add additional time to the review process. If authorization of your permit is appealed, please be aware that you may be responsible for all or a portion of the costs required to process the appeal. For projects located within the Coastal Zone, no fee will be charged for appeals, per the California Coastal Act. For appeals of projects unrelated to a violation and located within the non-coastal zone, the following applies:

• A fee of $1,000 will be required of the project appellant at the time the appeal is submitted.• Appellants who are also project applicants will be responsible for all charges for staff time to

process the appeal.

• Where the appellant is not the project applicant, the appellant will be responsible for the initial$1,000 and the applicant will be responsible for actual staff time and costs in excess of theinitial $1,000 appeal fee, up to a maximum of $2,000.

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• When the appeal is fully upheld, the full fee for the appeal will be refunded. If upheld in part,the decision-making body will determine how much of the costs will be refunded.

Prior to submitting your application, it is imperative that you fully familiarize yourself with the laws, ordinances, regulations, policies, and procedures that apply to your application. You should also consult with appropriate experts (e.g., land use consultant, civil engineer, floodplain specialist, geologist, or biologist) that can assist you in preparing the necessary reports, plans, studies, and other documentation normally required to process your application. Although County staff are available to provide assistance, ultimately it is your, and your consultant’s, responsibility to ensure that the requisite information and materials are complete and included in your application packet. For a fee, you may request a presubmittal review from a specific agency or department. (The estimated minimum time for a presubmittal review is two weeks.) County staff (i.e., subject matter experts) who are responsible for reviewing your application are listed in Subsection I.C (pg. 6)).

I.B. Advisory Information

Please be aware that certain areas of the County are subject to prohibitions on development and/or are subject to General Plan policies and Zoning Ordinance regulations that may preclude County staff from making a recommendation of approval to decision-makers on certain types of projects. Therefore, please review the following information prior to preparing an application to determine if the proposed project is subject to any of these prohibitions on development, policies, or regulations:6

• Zoning Violations and Illegal Lots: Pursuant to the NCZO (§8111-2.2.f) and the CZO (§8181-5.1.e), an application for new entitlements or a time extension of an existing entitlement shallnot be processed if a violation of Division 8, Chapters 1 or 2, of the Ventura County Code existon the subject property, unless the acceptance of the application is necessary to abate theexisting violation. An application for a discretionary entitlement shall not be accepted forprocessing if a Notice of Violation is in effect on the subject property—unless the discretionaryentitlement is required in order to abate the violation that is the subject of the Notice ofViolation.

• Illegal Lots: Pursuant to State law [Government Code, §66499.30(a) and §66499.30(b)] theNCZO (§8101-3.4 and §8111-1.2.1.1.f) and the CZO (§8171-4.4, §8175-5.1a, and §8181-2), adiscretionary entitlement can be approved only for projects that would be located on a legal lot.For more information on how to determine if a project site would be located on a legal lot,please visit http://vcpublicworks.org/general/county-surveyor-legal-lot-determination.

• Abandoned Water Wells: Pursuant to the County of Ventura’s Groundwater ConservationOrdinance No. 4184 (§4819.A), if an abandoned water well exists within the proposed projectarea, you must obtain a well destruction permit from the Ventura County Watershed ProtectionDistrict and destroy the well, prior to submission of an application for a discretionary

6 The following list does not constitute an exhaustive list of the moratoria, policies, and regulations that could result in County staff making a recommendation of denial of your application to decision-makers.

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entitlement, subdivision, or legislative action. In addition, an application for a discretionary entitlement, shall not be accepted for processing if a Notice of Non-Compliance is in effect on the subject property.

• Biological Resources: To the extent feasible, wireless communication facilities should not besited in environmentally sensitive areas. If alternative sites are not available, facilities that arelocated on or adjacent to land that contains native vegetation or trees, or are located within300 feet of a watercourse, drainage, or wetland may require an Initial Study BiologicalAssessment (ISBA). To determine whether an ISBA is needed, please consult with thePlanning Division prior to application. If an ISBA is needed, a biological consultant from thePlanning Division’s list of Qualified Biologists may be contracted to conduct a survey andcomplete an ISBA report in the standard report format. Prior to hiring a biologist that is not onthe qualified list, the biologist should contact the Planning Division in order to demonstrate his/her qualifications and to get a copy of the Planning Division’s ISBA report template. Failure toadhere to these procedures will result in costly peer reviews and the need to reformat the ISBA.

Focused Surveys: One or more focused surveys for special-status plants or animals may be necessary to complete the ISBA report. It is important to note that, if focused surveys are necessary, these surveys are often restricted to a specific time of the year. For instance, a sensitive plant survey must be conducted during the flowering period(s)—typically springtime—of any sensitive species that is likely to occur within the project site. The sensitive plant survey must be conducted prior to completion of an Initial Study for the project; therefore, unless a sensitive plant survey has recently been conducted on the project site, the preparation of a sensitive plant survey could delay the processing of your application. For more information on the rules, regulations, and procedures for analyzing potential impacts to biological resources, please visit: https://www.vcrma.org/biological-resources Design for Migratory Birds: Wireless communication facilities should be designed to minimize impacts to raptor, California Condor, or waterbirds. Facilities which are proposed in concentration areas, daily movement routes, or in diurnal migratory routes for these types of birds should have daytime visual markers on any guywires. Also, no additional lighting is allowed other than that which is required by the Federal Aviation Administration (see NCZO §8107-45.4(s)(1) for projects located outside of the Coastal Zone; and CZO §8175-5.20.3(t)(3) for projects located within the Coastal Zone).

• Radio Frequency Emissions Report: Documentation prepared and signed by a qualified radiofrequency engineer that demonstrates the proposed wireless communication facility willoperate in compliance with Sec. 1.1301, et seq., of Title 47 of the Code of Federal Regulationsor any successor regulations is required for all wireless communication facility permits. Thereport should include analysis of FCC compliance at both the ground-level below the wirelesscommunication facility and wherever terrain or placement of buildings could cause exposure.Individual and cumulative emissions should be evaluated.

• NPDES Construction Activities Stormwater General Permit: Construction activity resulting in aland disturbance of one acre or more, or less than one acre but part of a larger common plan ofdevelopment, must obtain the Construction Activities Stormwater General Permit (2009- 0009-DWQ Permit). Construction activity includes clearing, grading, excavation, stockpiling, andreconstruction of existing facilities involving removal and replacement. Construction

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activity does not include routine maintenance such as maintenance of original line and grade hydraulic capacity, or maintenance consistent with the original purpose of the facility.7

• Compliance with Ventura County NPDES Stormwater Permit: Any applicable constructionactivity shall comply with requirements for construction projects including Best ManagementPractices (BMPs) listed under the Part IV.F “Development Construction Program” of theVentura County NPDES Stormwater Permit. For more information regarding this permit, referto www.vcstormwater.org or call (805) 650-4064.

7 For more information regarding the permit, contact State Water Resources Board at [email protected] or phone (916) 341-5537, or refer to website at http://www.swrcb.ca.gov/water_issues/programs/stormwater/constpermits.shtml

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I.C. Discretionary Permit Application Review Staff

Agency or District Subject Matter Contact Contact Information

Watershed Protection District Drainage Shweta Chervu (805) 654-2454 [email protected]

Watershed Protection District Groundwater/Water Supply Kim Loeb (805) 650-4083 [email protected]

Watershed Protection District Surface Water Quality Ewelina Mutkowska (805) 645-1382 [email protected]

Public Works Agency Grading Jim O’Tousa (805) 654-2034 [email protected]

Public Works Agency Geology and Soils Engineering Jim O’Tousa (805) 654-2034 [email protected]

Public Works Agency Floodplain Management (FEMA) Raymond Gutierrez (805) 654-2059 [email protected]

Public Works Agency Transportation, Circulation, Traffic, and Drainage Darren Arrieta (805) 477-7157 [email protected]

Public Works Agency Subdivisions and Parcel Map Waivers Wayne Battleson (805) 654-2089 [email protected]

Public Works Agency Solid Waste, Greenwaste, and Recycling Tobie Mitchell (805) 658-4315 [email protected]

Ventura County Air Pollution Control District Air Quality and Climate Change Nicole Collazo (805) 645-1426 [email protected]

Resource Management Agency, Environmental Health Division

Water Supply, Sewage Disposal, Public Health, Hazardous Materials/Waste, and Solid Waste Operations

Rebecca Lustig (805) 654-3520 [email protected]

Ventura County Fire Protection District Fire Protection Ruben Luna (805) 914-8801 [email protected]

Agricultural Commissioner’s Office Agricultural Resources Korrinne Bell (805) 933-2926 Monica Sanoja

Resource Management Agency, Planning Division

Land Use, Planning, and Permit and Environmental Review Processing Winston Wright (805) 654-2468

[email protected]

Public Works Agency Water and Sanitation Eric Keller (805) 378-3015 [email protected]

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Section II – Checklist for Plans and Technical Information (11/28/2017) Page 1 of 16

This section requests materials for each of the following: A) Site Plans, including Preliminary Grading PlansB) Conceptual Landscape PlanC) Technical Illustrations for Visual Impact Analysis and Propagation Diagrams

Building/Facility Elevations for AntennaD) Facility ElevationsE) Floor PlansF) All Plans/MapsG) Alternative Sites Analysis

II.A. Site Plans/Preliminary Grading Plans

Applicability The following checklist outlines the submittal requirements for site/preliminary grading plans for a Discretionary Land Use Entitlement for a wireless communication facility (i.e., Conditional Use Permit) applications. Please submit a site/preliminary grading plan that meets the following requirements. Site/Preliminary Grading Plan Requirements Site/preliminary grading plans must comply with the following requirements:

Site/Preliminary Grading Plan Requirement Required

Submittal Requirements 1. Submit 20 hardcopies of the site/preliminary grading plan, folded to no larger than 8.5 x 14

inches.2. Submit a digital copy of the site/preliminary grading plans on a CD.

GIS or CAD files of the plans should be provided unless the plans were not prepared usingAutoCAD, in which case a PDF or the hard copy of the plans will suffice. The acceptedformat of the plans is as follows (in order of preferred format): (1) GIS files; (2) CAD files;(3) Digital files (PDF, JPG, TIF); and, (4) Hard copy, at least 24 x 36 inches in size. If yousubmit GIS or CAD files, provide the files in the following format:• CAD files in DWG format;• CAD or GIS files in the Ventura County standard projection: NAD 1927 State Plane CA Zone

V (feet); and,• CAD or GIS files with only grading limit lines (daylight lines) and proposed structures.

Dimension/Orientation Requirements 3. Site plans must comply with the following dimensional and orientation requirements:

a. Site Plans must be a minimum of 24 x 36 inches in size.

2488 www.vcrma.org/divisions/planning

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Site/Preliminary Grading Plan Requirement Required

(1) For projects that are proposed on large lots (i.e., 20 acres or larger in size), include an enlargement/detailed drawing of the areas of proposed development.

b. Site plans must be oriented such that the northerly side of the project site is at the top of thesite plan.

c. Site plans must be drawn such that they are legible, and must be drawn using an engineer’sscale within the range of 1 inch = 10 feet to 1 inch = 200 feet.

Title Block Requirements 4. Site plans must include a title block that complies with, or includes, the following:

a. Title blocks should be located in the lower right-hand corner of the site plan, unless analternative location exists that would make the title block more legible (e.g., the right-handside of the site plan).

b. For plans that are submitted in digital format, all text within the title block must be largeenough to be legible (e.g., 12 point font).

c. Name and mailing address of the:(1) Property owner. (2) Structural Engineer. (3) Architect or Faux Equipment Manufacturer. (4) Other consultants or representatives (e.g., land use consultant).

d. Identify which individual listed in Items 4.c(1) through 4.c(4) (above) will serve as the contactperson for the project.

e. Assessor’s Parcel Numbers of all Tax Assessor Parcels on which the project site is located.f. Project site address and latitudinal/longitudinal coordinates of the facility.g. Carrier identification site name or number.h. Date that the site plan was prepared.1

Vicinity Map Requirements 5. Site plans must include a legible vicinity map that identifies the location of the subject

property within the community. The map shall include the following:a. North arrow and a graphic and numeric scale.b. Existing street pattern with names (from the property to the first public road) and the nearest

cross-street. If the property is 0.5 mile or more from the nearest public road, an approximatedistance must be shown.

c. The project site and lease area

Project Information List2 6. Site plans must include a list of the following project-related information:

a. General Plan, Area Plan, and zoning designations of the project site and adjacentproperties.3

1 Any future revisions made to the plans must include a revision schedule that lists the revisions that were made and the date of each revision. 2 All recyclable debris generated during construction projects must be recycled or reused per County Ordinance No. 4421, which may be viewed at www.vcpublicworks.org. 3 The land use and zoning designations may be obtained from the Planning Division Public Information Counter. Alternatively, zoning designation information is available on-line at:http://gis.ventura.org/countyview/ . Land use designation information is available in the Ventura County General Plan Goals, Policies and Programs (2008, Figures 3.1a and 3.1b), which is available on-line at: https://www.vcrma.org/ventura-county-general-plan.

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Site/Preliminary Grading Plan Requirement Required

b. Gross and net lot area.4

(1) If the project site constitutes only a portion of the lot on which it is located, provide the size of the project site.5

c. List or include a table of all buildings and structures (including equipment sheds for wirelesscommunication facilities) and include the following information about each:(1) Label as to whether or not the building or structure is existing or proposed. (2) For existing buildings and structures, identify which will be modified (e.g., partially or

fully demolished,6 remodeled, or added onto). (3) The existing or proposed use of each building or structure, as follows:

(a) Describe the type of wireless communication facility using the descriptions provided in the: (a) NCZO (§8105-4 and §8105-5) for projects located within inland areas of the County; or, (b) CZO (§8174-5) for projects located within the Coastal Zone of the County.

(b) If the facility is mounted on a building, describe the primary building use. (c) If the facility is mounted on a structure which was originally designed for a different

purpose, describe the primary structure use. (4) The gross floor area of each building, equipment shed, and equipment boxes. (5) The building and structure coverage size in square feet. (6) For existing buildings or structures, indicate the approximate age of the building or

structure.7 d. The total gross floor area for all buildings and structures.e. The total net building coverage for all buildings and structures. Building Coverage (%) =

(Total Area of Building and Structural Coverage) / (Lot Size).f. Existing and proposed outdoor uses, including the type of outdoor use (e.g., open storage, ,

landscaping, operations yards, trenches for electrical connections, drainage systems, andaccess roads) and the size of the area (in sq. ft.) dedicated to the outdoor use.

g. Statistics on the amount of impervious and pervious surfaces, including:(1) Permanent and temporary buildings and structures. (2) Paved surfaces (e.g., driveways, walkways, parking areas, and loading areas). (3) Pervious surfaces and structures (e.g., landscaped areas, grasscrete, or bioswales).

h. Grading statistics (in cubic yards), including:(1) Cut. (2) Fill. (3) Import. (4) Export.

4 For the definitions of “gross lot area” and “net lot area”, see the NCZO (§8102-0) for projects located outside of the Coastal Zone; and CZO (§8172-1) for projects located within the Coastal Zone. 5 If the project site would occur on a leased portion of the subject property, submit a copy of the lease. 6 All recyclable debris generated from demolition projects (e.g., concrete, asphalt, wood, metal) must be recycled or reused per local, regional, and state laws and regulations. For regulations relating to the disposal, recycling, or reuse of inert materials (e.g. concrete, asphalt, dirt) contact the Ventura County, Resource Management Agency, Environmental Health Division and/or review www.CIWMB.ca.gov/Regulations/Title14/ch3a595a.htm. For more information on the County’s requirement to divert recyclable materials, as required by Ordinance 4421 go to www.vcpublicworks.org. 7 See Section III, “Discretionary Entitlement for Wireless Communication Facility Application Questionnaire,” Item H.16. Buildings or structures that are at least 50 years old might qualify as historical resources, the impacts to which are required to be analyzed as part of the environmental review of the project.

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Site/Preliminary Grading Plan Requirement Required

i. Type and amount (i.e., total surface area in square feet and/or acres) of vegetation removalincluding (but not limited to) prime farmland and what is required for fire clearance zones.8

j. List or proved a table of protected trees9 to be removed, altered or encroached upon,including:(1) Tree species. (2) Girth. (3) Indicate whether the tree is located in an easement. (4) Action requested (removal, alteration or encroachment).

Graphic Illustration Requirements 7. The following must be graphically illustrated on the site plan and drawn to scale:

a. North arrow.b. The scale used in drawing the site plan.c. All lot lines with dimensions in feet.d. The footprint, as well as eaves that project into setback areas, of existing and proposed

buildings and structures, including the following: (1) Label the existing and/or proposed use of buildings and structures and/or provide a

clear cross-reference to the respective building or structure in the list of project-related information.10

(2) The following property features must be shown (if applicable): (a) Existing wireless communication facilities. (b) Existing vegetation or topography which will be used to conceal the facility. (c) Fuel tanks and batteries. (d) Cisterns, underground water storage, wells, and septic systems.

e. Setback dimensions (from property lines to structures) and distances between buildings andstructures measured in feet.

8 Projects that are located within areas of intact native vegetation and, consequently, have the potential to adversely impact endangered, threatened, or rare plant species, plant species that are included on the Ventura County List of Locally Important Species, or California Native Plant Society listed species, will require the preparation of a sensitive plant survey by a qualified biologist. The sensitive plant survey must be conducted during the flowering period(s)—typically springtime—of the species that are likely to occur within the project site. The sensitive plant survey must be conducted prior to completion of an Initial Study for the project; therefore, unless a sensitive plant survey has recently been conducted on the project site, the preparation of a sensitive plant survey could delay the processing of your application. For more information on the regulations and procedures for analyzing potential impacts to biological resources, see: https://www.vcrma.org/biological-resources 9 Projects in the non-coastal zone on private property that involve major pruning, removal, trenching, excavation, or other encroachment into the tree protection zone (the area 5 feet outside the dripline or 15 feet from the trunk, whichever is greater) of protected trees must conform to the County’s Tree Protection Ordinance (TPO). Projects in the coastal zone must conform to CZO Sec. 8178-7. Protected trees are defined differently between the non-coastal zone and coastal zone. See NCZO Sec. 8107-25.2, Table 1, and CZO Sec. 8178-7.3 for protected tree definitions. You must consider the protected trees that are directly part of your request, as well as other protected trees whose tree protection zones (TPZ) are within 20 feet of the limits of the proposed construction area (including access drives and utility easements) or within 20 feet of other trees proposed for removal. This includes trees growing on adjacent parcels if their TPZ extends onto the subject parcel.

An Arborist Report that conforms to the County’s requirements will usually be required as part of the application process. See Submittal Requirements for Tree Permits and Authorizations or CZO Sec. 8178-7.7 for more information. Approval to remove or alter a protected tree will only be granted under the circumstances outlined in these documents. If minor pruning can solve a compatibility problem, then tree removal will generally not be approved. Protected trees may not be removed for aesthetic or view reasons. Note that it is a violation to prune or trim protected trees in a manner that does not adhere to International Society of Arboriculture standards. 10 See Item 6.c, above.

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Site/Preliminary Grading Plan Requirement Required

f. Delineation and label of the permit area, as well as all areas that would be subject to outdooruses (e.g., temporary or permanent storage yards, landscaping, etc.) and/or restrictivecovenants.

g. Delineation and label of construction equipment maintenance and staging areas.h. Areas that will be subject to the use, storage, and/or handling of hazardous materials.i. Physical features of the site, including:

(1) Protected trees whose tree protection zones are within 20 feet of the limits of the construction area (including access drives and utility easements) or within 10 feet of other trees proposed for removal. Include (approximate location of) trees on adjacent parcels that meet these criteria if the tree’s protected zone extends over the property line of the subject parcel. Include the following information: (a) Location. (b) Species. (c) Girth of trunk measured at 4.5 feet above natural grade.11 (d) Approximate delineation of the tree’s dripline. (e) Label if the tree is going to be altered or removed. (f) Any grade changes or trenching proposed within the tree’s protected zone. (g) Number the trees if more than one.

(2) Approximate delineation of native vegetation on site. (3) Location of significant biological resources on site, as identified by an Initial Study

Biological Assessment (e.g., special status plants, sensitive plant communities, animal dens or nests, or wetland habitat).

(4) Delineation of 100-foot setbacks from wetland habitats and/or other recommended setbacks identified in the Initial Study Biological Assessment.12

(5) Existing and proposed utilities (e.g., electrical, water, and sewer lines and/or poles), including the Point of Connection to the facilities that will serve the project.

(6) Existing and proposed topographic contours. (7) Existing and proposed hydrological conditions/drainage patterns and infrastructure,

including (but not limited to) the following: (a) Drainage at a minimum 2% slope away from foundations. (b) Watershed Protection District facilities. (c) Connections to Watershed Protection District, Transportation Department facilities,

and other facilities. (d) Detention basins and/or other drainage facilities. (e) Surface water quality treatment devices (e.g., bioswales or desiltation basins). (f) Additional drainage to public road rights-of-way and road improvements. (g) Red and blue line streams,13 as well as any other known on-site drainage course.

(8) Top of stable (hydrological) bank of creeks and drainages.

11 The girth measuring position may vary depending upon where the waist of the tree is—the narrowest trunk point is typically the goal—and many other factors. If there are multiple trunks, measure each and add their measurements together; for heritage trees only the two largest trunks are measured. 12 Ventura County General Plan, Policy 1.5.2, #4 requires that discretionary development be sited a minimum of 100 feet from significant wetland habitats. 13 Information on the location of red and blue line streams may be obtained from the Resource Management Agency GIS Department. Contact Mr. Jose Moreno, M.A., GISP, GIS Supervisor, at (805) 477-1585, or [email protected], to obtain this information.

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(9) Areas with geologic formations that have undetermined, moderate, or high paleontological importance.14

(10) Delineation of the top and bottom (toe) of slopes. (11) Delineate and label Geologic Hazard Areas,15 (including but not limited to):

(a) Earthquake Fault Hazard Zones (Fault Rupture). (b) Seismic Hazard Zones (Liquefaction & Earthquake Landslides). (c) Landslides.

j. Existing and proposed paved areas, including (but not limited to) the type of surfacing,whether it is pervious or impervious, and widths of all walkways.

k. Location, width, recorded document number, and recorded use of existing and proposedeasements.

l. Existing fire hydrants, including the following:(1) Location. (2) Type of hydrant (e.g., wet, dry, or drafting). (3) Number and size of outlets (i.e., one 4 inch and one 2-1/2 inch).

m. Location, height of wireless communication facility equipment:(1) Antenna and support structures (includes buildings), measured pursuant to NCZO

§8107-45.4(f)(1) for facilities in the Non-Coastal Zone or CZO §8175-5.20.3(h) forfacilities in the Coastal Zone.

(2) Roof features for building-mounted and roof-mounted wireless communication facilities. (3) Freestanding or facility-mounted light fixtures, with labels indicating the proposed type

and intensity of the lighting. (4) Walls (including, but not limited to, retaining walls and site-enclosure walls). (5) Fences with a label of the proposed type of fencing (e.g., wood, chain link, CMU, or

wire). Also see NCZO §8107-45.4(r) or CZO §8175-5.20.3(s) for limitations on chain link fencing in some zones.

n. Show the location of existing and proposed signs:(1) Pursuant to NCZO §8107-45.4(t) in the Non-Coastal Zone or CZO §8175-5.20.3(u) in

the Coastal Zone for wireless facility sign standards. (2) Required for FCC compliance.

o. Roadway features including:(1) Show the following information for adjacent and on-site public and private streets.

(a) Delineation of the right-of-way for public streets and easement line with the recorded document number for private streets (map citation).

(b) Street name. (c) Cross section of the existing road and proposed road improvements. (d) Edge of pavement and/or concrete. (e) Street frontage features (e.g., curbs, gutters, and sidewalks). (f) Lane configurations. (g) Signage, including on-site and adjacent roadway traffic signs. (h) Traffic signals. (i) Street lights.

14 See the Ventura County Initial Study Assessment Guidelines (2006, Chapter 9) for a list of the geologic formations that have undetermined, moderate, or high importance. 15 For a definition and maps identifying the location of Geologic Hazard Areas, see the Ventura County General Plan Hazards Appendix (2005), available at: https://www.vcrma.org/ventura-county-general-plan.

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Site/Preliminary Grading Plan Requirement Required

(j) Utility poles. (k) Bicycle lanes. (l) Pedestrian crossings. (m) Islands and medians. (n) Existing and proposed curb cuts (e.g., driveway and private roadway entrances

from the road to the project site). (o) Identify the Ventura County Roadway Plate that was used to design the roadway,

in order to achieve consistency with the Ventura County’s Roadway Standards and the Ventura County Fire Protection District’s access standards.

(p) Any improvements that would require an Encroachment Permit from the Transportation Department (e.g., trenching for the placement of utilities or pipelines).

(2) Access road(s)/driveway(s) features including:16 (a) Location. (b) Width. (c) Surface type. (d) Proposed grades. (e) Ventura County Fire Protection District turnarounds. (f) Existing and proposed access road gate locations. (g) If the project involves the use of off-site access roads/driveways, show the public

right-of-way or recorded ingress/egress easement locations. Copies of easements may be required prior to project approval.

(h) Sight distance.17 (3) Layout and dimensions of the parking area for maintenance trucks, including: drive

aisles and direction of travel; equipment assembly areas; loading spaces; p. Areas of vegetation removal including (but not limited to) what is required for:

(1) Fire protection purposes. If there is natural brush within 100 feet of the wireless communication facility, delineate a 100 foot brush clearance limit line around the facility. Delineate the limit line on adjacent lots if the 100 foot zone crosses a lot line.

(2) Wireless communication facilities, support structures, and buildings. (3) Landscaping.

8. For projects located within a FEMA-designated Special Flood Hazard Area (100-yearfloodplain), submit 2 copies of a floodplain site plan, folded to no larger than 8.5 x 14inches, which includes the following information:18

a. List the National Flood Insurance Program (NFIP) FIRM number, panel, suffix, and dates ofthe Effective (current approved) and any Preliminary Map.

b. Accurately delineate the FEMA floodplain boundary, and Regulatory Floodway boundary asdetermined on the current-approved “Effective” Flood Insurance Rate Map (FIRM), and most

16 For all projects in which the project site is not located adjacent to a public road right-of-way, submit documentation (e.g., a recorded access easement/title report) that demonstrates legal access to the property from the nearest public road. 17 For information on the sight distance requirements, see the Transportation Department’s “Sight Distance” brochure, which is available on-line at: http://pwaportal.ventura.org/TD/Residents/Streets_and_Transportation/FAQs_and_Citizen_Brochures/Brochure_SightDistance.pdf Also, see the NCZO Sec. 8106-8.4) for projects located within inland areas of the County, and the CZO Sec.8175-3.8, Sec. 8172-1, and Sec.8175-3.11) for projects located within the Coastal Zone. 18 County of Ventura Floodplain Management Ordinance; Title 44 Code of Federal Regulations Sections 59, 60, 65 and 70.

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Site/Preliminary Grading Plan Requirement Required

recently released Preliminary FIRM to be completed by either a California licensed civil engineer or architect.

c. Topography must be drawn at one-foot contour intervals, unless impractical.d. For projects located immediately outside of FEMA-designated floodplain areas (within 100

feet of a floodplain boundary), topographic contour lines must be drawn within a range of 1to 10 foot contour intervals.

e. Identify and label existing and proposed habitable and non-habitable structures above andbelow ground tanks, utilities, site grading, and temporary and permanent construction andnon-construction storage areas.

f. Identify and label any wetland areas, which are located on and immediately adjacent to thesubject property, as identified on the County of Ventura’s latest available GeographicInformation System database.

g. Label the appropriate FEMA flood zone(s) on the subject property.h. Identify the base flood (100-year) elevation using the NGVD 1929 datum.

II.B. Conceptual Landscape Plan Submittal Requirements

Applicability The following checklist outlines the submittal requirements for conceptual landscape plans when applicable. Conceptual landscape plans must be consistent with Landscape Design Criteria19, include an irrigation plan, and be drawn by a licensed landscape architect. All applications for new and expanding wireless communication facilities which require landscaping, or where required landscaping will be modified, should include a conceptual landscape plan. Faux tree height limits are based on existing tree heights. For faux tree height limits in the Non-Coastal Zone, see NCZO §8107-45.4(f)(4), and see CZO §8175-5.20.3(h)(4) for faux tree height limits in the Coastal Zone Ifthere are no existing trees near the proposed faux tree, there may be tree planting requirements. Please see NCZO §8107-45.4(i)(4)or CZO §8175-5.20.3(k)(4)) for tree planting requirements, as these standards may affect the landscape plan and the authorized height of the wireless communication facility.

Final landscape plans will be required prior to issuance of building permits. Pursuant to NCZO §8107-45.4(q) and CZO §8175-5.20.3(r), new landscaping shall not incorporate any invasivespecies, as defined by the California Invasive Plant Council (Cal-IPC). Color photo simulations of the landscape must be provided (see Visual Impact Analysis in section II.C. for more information).

Conceptual Landscape Plan Requirement Required

Format 1. Copies: Submit 2 hardcopies of the plan.2. Size: Minimum of 24 x 36 inches, folded to no larger than 8.5 x 14 inches. Also include one

set of 8.5 x 11 inch reductions.

19 The Landscape Design Criteria can be accessed here: http://docs.vcrma.org/images/pdf/planning/brochures/Landscape_Design_Criteria.pdf

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Conceptual Landscape Plan Requirement Required

3. Orientation: Include north arrow shown on each sheet, except detail.4. Scale: Plans must be at a scale of 1 inch = 30 feet or larger. For large projects with simple

landscapes the scale can be reduced to 1 inch = 40 feet if all symbols are legible, ormultiple sheets can be used. Provide bar scale on the plan.

5. Lettering: All lettering must be legible and 1/8 inch or larger.6. Page numbering: Number sheets consecutively: "Sheet ___ of ___".7. Screening elevations: Where screening will be provided by a fence, wall or vegetation,

provide scaled elevations, or photo simulations, of the screening.8. Note: Symbols/illustrations/simulations representing new plants should convey plant size at

approximately 5 years growth. Pursuant to NCZO §8107-45.4(i)(4)(b) and CZO §8175-5.20.3(k)(4)(c), §8175-5.20.3(r)(2) planted trees used to screen the facility from publicviewpoints must reach 75% of the faux tree height within five (5) years.

9. Title block: Locate on the right-hand edge of each sheet, unless an alternative locationwould make it more legible. Include:a. Plan title.b. Project title/name.c. County project number (if assigned yet).d. Assessor’s parcel numbers (APNs) of all parcels on which the project is located.e. Project address (if any).f. Landscape architect’s name, license or seal expiration, signature and date signed.g. Certified Arborist’s name, license or seal expiration, signature and date if trees are illustrated

with 5 years of average growth pursuant to NCZO §8107-45.4(f)(4)(b)(iii) or §8107-45.4(i)(4)(b) and CZO §8175-5.20.3(h)(4)(b)(iii).

h. Date of plan.

Title Sheet 11. The first sheet of the plan must be a title sheet and include the following:

a. Name, address, email address, and phone number of: landscape architect; otherprofessionals who worked on plans such as engineers, arborists or surveyors; and theowner/developer.

b. Notation: "Conceptual Landscape Plan For Plan Check Only."c. Landscape plans must include lists of the following project-related information:

(1) Total square footage of: project site, parking/assembly area, equipment enclosures, and total landscaped area.

(3) Total square footage of landscaping which will be irrigated. (4) Number, type and approximate size of existing trees to be removed or retained in the

irrigated landscape. Indicate those that have protected tree status. (5) Number, type and container size of proposed trees (see NCZO §8107-45.4(i)(4)(e) or

CZO §8175-5.20.3(r)(4)). (6) List of the species and quantity of all plants proposed.

Project Concept Notes 12. It will expedite plan review if the landscape architect includes brief project notes which point out

the features in the proposed landscape which achieve the following functions of landscaping. Notall functions of landscaping will be appropriate for all projects.a. Screening from public viewpoints.b. Visual relief and/or visual integration.

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Conceptual Landscape Plan Requirement Required

c. Compatibility with community character.d. Shade and improved aesthetics of paved areas.e. Slope stabilization.f. Restoration of disturbed land to its natural state.g. Height of planted trees after five (5) years.h. Maximum height of tallest existing tree which is within a 150-foot radius of the project.i. If the facility is a faux tree, the allowable height depends on the characteristics of existing

trees as follows:(1) Include brief notes regarding whether the facility will be screened by an existing tree

canopy (dense trees with intersecting branches), or by non-canopy trees which are located within 150 feet of the proposed facility.

(2) Include brief notes regarding how the wireless facility design will compliment species-specific anatomical characteristics of existing nearby trees.

Graphic Illustrations 13. The following existing or proposed features must be graphically illustrated and called out.

a. Lot lines (with dimensions in feet), adjacent street names, use and zoning of adjacentproperties.

b. Buildings, structures, driveways, parking areas, pedestrian pathways and other hardscape ornonplantable features. Include feature dimensions.

c. Features, such as equipment sheds or loading areas, that require landscape screening.d. Light poles.e. Walls, retaining walls, fences. Provide a concept detail of fences, gates, walls, retaining

walls and plantable walls showing layout and height.f. Utility and access easements, and overhead lines.g. Engineered slopes, walls and grades. Indicate the top and toe of all significant slopes.h. Important natural features such as drainages and rock outcroppings.i. Fuel modification zones.j. Existing protected-status trees (including those on adjacent parcels if the tree’s protected

zone extends over the property line), to be removed or retained, including type and size.k. Landscape planters/areas, including a general idea of the proposed plant palette including

type and size. Include planter dimensions.l. New trees, including proposed type and size when planted and size after 5 yearsm. Irrigation, water harvesting or stormwater management landscape features (labeled).n. Sight distance triangles at street intersections.

II.C. Technical Illustrations for Visual Impact Analysis and Propagation DiagramsApplicability Visual impact analysis may be required to determine if the wireless communication facility blends with the surrounding environment pursuant to the Ventura County General Plan, Goals Policies and Programs, §4.5.2-4. Low height is one method to minimize aesthetic impacts, and propagation diagrams may be required to determine if the facility is the minimum height necessary to provide adequate service.

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Visual Impact Analysis: Photo simulations and other information may be required to determine the visual impact of the proposed wireless communication facility on the existing setting or to determine compliance with design standards. The photo simulations shall include “before” and “after” renderings as seen from public viewpoints. Each simulation shall include the proposed facility, antennas, and any structures, vegetation, or topography that will screen the proposed facility from multiple public viewpoints. This information will be used to determine if the wireless communication facility is prominently visible from a public viewpoint.20

Propagation Diagrams: A set of maps showing the location of the provider’s existing facilities, existing coverage or capacity area, and the proposed coverage or capacity area at varied antenna heights is required if the proposed facility would exceed 40 feet in height in the Non-Coastal Zone, or if it would exceed 30 feet in the Coastal Zone, and may be required at lower heights if the facility is located on a ridgeline, within a Scenic Resource Area, or in an Urban Residential Zone. If capacity cannot be illustrated on a map, an engineering report may be submitted for review by the County or the County’s consultant. Additional types of analysis may be required to demonstrate the need for a facility height that would achieve a line-of-sight connection in view of potential obstructions such as buildings, topography, or vegetation.

In addition to the information listed below, permits for wireless communication facilities are also subject to Ventura County’s Guidelines for Preparation of Environmental Assessments for Scenic Highways and Scenic Resource Areas.

Visual Impact Analysis 1. Provide three complete sets of “existing” and “proposed” color 11” x17” photo simulations

drawn to scale with the following in each set:a. Ariel photograph (with source and date photo was taken) inset map at a large scale showing

the vicinity of the facility location.b. Three existing and proposed public views, each from approximately a ½ mile, 1 mile, and 2

miles from the proposed facility.c. One close-in simulation for building-mounted facilities that demonstrates the facility is

consistent with architectural features.d. One landscape simulation at approximately 1 inch = 30 feet or larger.e. Faux design elements on the wireless facility (e.g., faux material size, color, and texture).f. Existing and proposed trees, building features, and topography which may be used to

screen the facility.g. Landscape conceptual design including types, sizes and textures of plants; screening; and

massing.h. For a non-stealth facility, include a simulation showing whether the maximum allowable

Section 6409(a) Modification would cause the facility to become prominently visible from apublic viewpoint.

Propagation Diagrams 2. Provide three sets of color 11” x17” propagation diagrams with the following in each set:

a. A basemap showing the provider’s existing facilities, existing coverage or capacity area andlocational characteristics such as labeled roads, landmarks, and topography.

b. A map showing the proposed facility’s coverage or capacity area at intervals at least 10 and20 feet lower in height than proposed. This map should be scaled to match the basemap interms of scale and locational characteristics.

20 See NCZO §8102-0 or CZO §8172-1 for definition of “wireless communication facility, prominently visible.”

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c. Narrative description summarizing the findings in layman’s terms.d. If the proposed facility would exceed an area plan or zoning height standard, provide

propagation diagram to demonstrate two or more height-compliant facilities that demonstratecoverage objectives which cannot be met.

II.D. Wireless Communication Facility Elevations

Applicability The following checklist outlines the requirements for structure, equipment and antenna elevations for wireless communication facilities. Elevations should show the face of the building if the proposed wireless communication facility would not involve any changes to the exterior of the building or structure.21

Wireless Communication Facility Elevation Requirements Elevations from multiple perspectives shall be provided for all proposed wireless communication facilities. If antennas are enclosed in a faux structure such as a mono-rock or water tower, or are mounted on the exterior of an existing building or structure, detailed antenna and equipment elevations shall illustrate the structural design of the antenna in relation to the support structure.

Facility Elevation Plan Requirement Required

Submittal Requirements 1. Submit 4 copies of the facility elevations, folded to no larger than 8.5 x 14 inches in size.

Dimensional Requirements 2. Facility elevations must comply with the following dimensional requirements:

a. All sheets of the plans for facility elevations must be a minimum of 24 x 36 inches in size.b. All sheets of the plans for facility elevations must be drawn to an architectural scale within

the range of 1/8 inch = 1 foot to 1/4 inch = 1 foot, unless an alternative scale is required inorder to make the plans legible.

Informational Requirements 3. Facility elevations must include the following:

a. The title block information required on the site plan/preliminary grading plan.22

b. Graphic and numeric scale used in drawing the facility elevations.23

c. Buildings and structures must be labeled to indicate what building or structure is shown onthe elevations.

d. Four elevations of the exterior of structures and buildings labeled in terms of the directionthe elevation faces (i.e., north, south, east, or west).

e. Facility dimensions—both height and width—for each elevation. The facility height must bemeasured according to the definitions and methodologies stated in the: (a) Ventura County

21 Specifically, some types of building-concealed wireless communication facilities and facilities such as mono-rocks may not require exterior structural modifications such as additional architectural features. 22 See Section II.A, Item No. 4 (above). 23 See Section II.C, Item No. 2.b (above).

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Facility Elevation Plan Requirement Required

Non-Coastal Zoning Ordinance (§8107-45.4(f)) for projects located within the inland areas of the County; or, (b) Ventura County Coastal Zoning Ordinance (§8175-5.20.3(h)) for projects located within the Coastal Zone.

f. A description and sample of the colors, materials, and textures of the exterior surfaces ofeach elevation.

g. Blending treatments (e.g., faux tree materials, façade materials, and architecturaldelineation) shown on each elevation with the following specifications:(1) Paint and texture on exposed antennas, exterior cables and cable trays, pipes mounts,

brackets, etc. (2) Fiberglass Reinforced Plastic or Radio-Frequency (RF) transparent materials. (3) Materials used to conceal transition lines between old and new surfaces for building-

mounted facilities, such as skirts or shrouds. (4) New architectural features such as columns, mansards, parapets, pilasters, etc. (5) Pipe mounts and brackets which are smaller than the antennas. (6) Antenna socks or faux shrubs to conceal the antennas. (7) Design of existing antennas; faux trees, mono-rocks, light poles; flag poles; water

tanks, steeples, clock towers and other architectural styles, etc. (9) Design, material, height, radome diameter (faux light poles).

h. Fencing and FCC-required signage on each facility elevation, as well as all equipmentsheds, utility lines, and existing structures within the vicinity .

i. Architectural details of all walls, fences, and gateposts, including the height dimensions,materials, and colors.

j. For projects located within a FEMA-designated floodplain, show the base flood elevationplus one-foot freeboard above the base flood elevation on elevation drawings.

k. Existing and proposed grades.l. For projects located within the Coastal Zone, submit cross-sections of walk-in structures.m. For roof-mounted, building-concealed, and flush-mounted facilities that are located on or

near a roof, submit a roof plan including all applicable items listed in (a) through (l) above.4. FCC Compliance documentation prepared and signed by a qualified radio frequency engineer.

The following table may be used to determine the allowable height for faux trees located in the Non-Coastal Zone (see NCZO, §8107-45.4(f)(4)(b); for locations within the Coastal Zone, see CZO §8175-5.20.3(h)(b)).

Faux Tree Height Calculation Table for Wireless Communication Facilities Faux Tree Type Allowed Faux Tree Height in Feet if...

If No Trees within 150 feet

Sited in a Dense Tree

Canopy* Some (non-canopy) trees within 150 feet

Mono-Broadleaf 60 15 feet above the maximum tree canopy

height.

5 feet above the maximum height of existing, surrounding trees, unless a certified arborist

estimates average height of existing trees after five years (use primarily when only seedlings

and saplings are in vicinity of the site).

Mono-Elm** 60 Mono-Eucalyptus** 80

Mono-Palm 65 Mono-Pine 80

*Applicant must demonstrate that existing trees would obstruct coverage, the median height of the tree canopy must be at least 30feet high, and the faux tree must be sited behind the canopy relative to public viewpoints. **Faux Elm and Faux Eucalyptus are not allowed in the Coastal Zone (§ 8175-5.20.3(k)(4)(d)).

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II.E. Floor Plans

Applicability The following checklist outlines the requirements for floor plans. If your project does not involve the mounting of a wireless communication facility on a building, you do not need to submit floor plans; proceed to Section II.F.

Floor Plan Submittal Requirements Floor plans must comply with the following requirements:

Floor Plans Requirement Required

Submittal Requirements 1. Submit 4 copies of the floor plans, folded to no larger than 8.5 x 14 inches in size.

Dimensional Requirements 2. Floor plans must comply with the following dimensional requirements:

a. All sheets of the floor plans must be a minimum of 24 x 36 inches in size.b. All sheets of the floor plans must be drawn to an architectural scale within the range of 1/8

inch = 1 foot to 1/4 inch = 1 foot.

Informational Requirements 3. Identify floors, levels, attics, lofts, and basements of the buildings or structures, with labels

indicating the building or structure and the proposed use, square footage, occupant loadfactor and occupant load of each room.

4. Identify the location of the conduits, cables, hazardous materials and the equipment box.5. Identify the lease area for the wireless communication facility.6. Identify habitable floor area and storage areas.

II.F. All Plans/ Maps

All Plans/Maps Requirement Required

Submittal Requirement 1. Submit a reduced set of all plans and maps in an 8.5 x 11 inch format.2. Submit a copy of all plans and maps in electronic format

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II.G. Alternative Sites Analysis

Alternative sites analysis is required if the proposed wireless communication facility will be sited in any location that is not a preferred location. An alternative sites analysis includes at least five other potentially available sites, along with evidence demonstrating why each site would be infeasible. Please see summary tables 1 and 2 below and application section III.C for additional information.

Table 1: Alternatives and federal preemption summary for wireless communication facilities in the non-coastal zone.

Siting Criteria (Sec. 8175-5.20.3(d) and (e))

Alternative

Sites Analysis (Sec. 8107-45.3(f))

Federal Telecommunications

Act Preemption

(Sec. 8107-45.4(f)(5)(b)

Preferred Location

Neutral Location X

Non-Preferred Location X

Non-Stealth Facility > 50 feet in height

X X

*Sec. 8107-45.8 states that the County may contract for technical expert review for any proposed wireless communicationfacility in the non-coastal zone .

Table 2: Alternatives and federal preemption summary for wireless communication facilities in the coastal zone. Siting Criteria (Sec. 8175-5.20.3(d)) and Facility Type (Sec. 8175-

5.20.3(b))

Alternative Sites Analysis (Sec. 8175-

5.20.10(j))

Federal Telecommunications Act Preemption

(Sec. 8175-5.20.5)

Technical Expert Review (Sec. 8175-

5.20.3(a))*

Preferred Location

Neutral Location X

Non-Preferred Location X X

Non-Stealth Facility <= 80 feet in height

X X

Restricted Location X X X

Non-Stealth Facility > 80 feet in height

X X X

*Sec. 8175-5.20.8 states that the County may contract for technical expert review for any proposed wireless communicationfacility in the coastal zone

Alternative Sites Required

Submittal Requirements 1. Submit 1 copy of an aerial map showing the location of the proposed wireless facility, and

the location of at least 5 alternative sites, including any existing wireless facilities within a¼-mile of the proposed location.

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Alternative Sites Required

Informational Requirements (submit at least one for each alternative site) 2. Copies of any collocation letters or e-mails relevant to collocation on alternative sites.3. Propagation diagrams illustrating whether each alternative site would fill coverage gaps.3. Copies of any lease agreement letters or e-mails requesting to lease an alternative site.4. Radiofrequency emissions reports for any alternative sites which would result in an

exceedance of federal standards.5. Visual simulations for any alternative sites that would result in greater aesthetic impacts

than the proposed site.6. Photos of sensitive habitat that would be affected if the alternative site was selected or a

biological assessment conducted by a qualified biologist.

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STAFF USE ONLY

CASE FILE NUMBER: Date Received:

Land Use Designation(s): Zoning Designation(s):

Receipt Number: Deposit Fee Paid:

Previous Permit Numbers: Violation Numbers:

Pre-Submittal Planner: Date of Application Submittal:

Pre-Submittal Letter Date: Legal Lot Reference:

Proposed Use as Listed in the Use Matrix:

Interested in Collocation on proposed facility? (Yes/No) Lat/Long Coordinates for GIS:

III.A. Requested EntitlementPlease select which entitlement you are requesting:

New Permit Major Modification Minor

Modification Time Extension for a Non-Conforming

Facility

III.B. Project Description SummaryIII.B.1: Please provide a brief summary of the proposed wireless communication facility, describe how it wouldbe designed to blend with the existing setting, and how it would be designed to minimize impacts to the environment; including public views of ridgelines, sensitive habitats, and community character.1 If the wireless communication facility is proposed to be sited in the Non-Coastal Zone, please describe how the design would be consistent with Sec. 8107-45 of the Non-Coastal Zoning Ordinance (NCZO)2 If the wireless communication facility is proposed to be sited in the Coastal Zone, please describe how the design would be consistent with Sec. 8175-5.20 of the Coastal Zoning Ordinance (CZO). (Attach additional pages if needed.)

III.B.2. Will the proposed project be designed as a “non-stealth” facility?3 Yes No

III.B.3. Will the proposed project, after it is constructed, be modified pursuant to Section 6409(a) of the 2012Middle Class Tax Relief and Job Creation Act? Yes No

1 See General Plan Policy Section 4.5.2(4) and Coastal Area Plan Section 4.1.7. 2 See NCZO Sec. 8107-45.3(a) or CZO Sec. 8175-5.20.10 for project description guidance. 3 A “Non-Stealth Wireless Communication Facility is “Non-stealth” if it is not disguised or concealed and does not meet the definition of a stealth facility or building-concealed facility. See NCZO Sec. 8102-0 and CZO Sec. 8172-1 for definitions.

2488 www.vcrma.org/divisions/planning

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III.C. Alternative Sites AnalysisIII.C.1. Please describe below how the wireless communication facility siting location would satisfy the preferred,non-preferred, and restricted facility siting location requirements.4 If the facility is proposed on a “neutral” location, which is neither preferred nor non-preferred, please describe why the facility cannot be sited on the nearest preferred locations. If the facility is proposed on a non-preferred location, a sensitive location, or is proposed to be located within an area governed by an Area Plan with a policy which states that “several shorter facilities are preferable to one large facility”,5 please select five (5) other potentially available neutral or preferred sites, and include a map showing the location of these alternative sites (also include the proposed site). All existing wireless communication facilities within a 1/4-mile of the proposed site shall be evaluated as an alternative site for purposes of collocation.6 For each alternative which is infeasible, please include one or more of the following items to demonstrate why the site is not feasible (attach additional pages and supporting documents as needed).

• If collocation is technically infeasible, please include copies of correspondence, including letters orsuccessfully transmitted e-mails to other wireless facility operators which demonstrate that theengineering requirements cannot be achieved which would be needed to physically modify the collocationfacility. Explain below why collocation is infeasible.

• If the coverage or capacity service levels cannot be achieved on an alternative site, please includepropagation diagrams illustrating the coverage or capacity gaps which would occur if the proposed facilitywas to be sited on alternate sites. Please explain the coverage or capacity gaps below.

• If a lease agreement or access easement cannot be obtained for the alternative sites, please includecopies of certified letters or successfully transmitted e-mails to landowners or other facility operatorsdemonstrating that a lease or access easement could not be secured. Below, please provide a narrativeof the outreach effort to landowners and other facility operators.

• If an alternative site is infeasible because it would expose the public to radiofrequency electromagneticenergy fields which exceed federal standards, please provide a report which is signed by a qualifiedradiofrequency engineer demonstrating this analysis.

• If the alternative site would result in greater visual impacts, please include a visual simulation thatdemonstrates the visual impacts for the alternative site from the closest or most prominent public viewingareas, and explain below how the visual impacts on the alternative sites would exceed the visual impactsresulting from the proposed site.

• If the alternative site would result in greater impacts to sensitive habitat, please provide a biologicalassessment by a qualified biologist or ground-level photographic evidence of the physical setting whichwould be damaged and explain below how the impacts to sensitive habitat on the alternative sites wouldexceed the impacts to sensitive habitats from developing the proposed site.

4 See NCZO Sec. 8107-45.4(d) and (e) for preferred and non-preferred locations. Or see CZO Sec. 8175-5.20.3(e), (f), and (g) for preferred, non-preferred, and restricted locations . 5 See the Ojai Valley Area Plan and the Thousand Oaks Area Plan. 6 See antennasearch.com and/or the Planning Division’s wireless facility location website: https://www.vcrma.org/ventura-county-wireless-communication-facility-map.

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III.D. Summary of Technical Illustrations for Visual Impact Analysis and Propagation DiagramsA “stealth” wireless communication facility includes concealment features such as design (size, height, color, materials, and antenna types) or siting techniques to camouflage, partially conceal, or integrate the facility into the surrounding visual setting.7 If the proposed facility is a stealth facility, please proceed to item III.D.1. below, otherwise proceed to III.D.2.

III.D.1. Visual Impact Analysis for a Stealth Facility: Please describe the “before” and “after” photosimulationsubmittals, which for a ground-mounted facility should be based on the closest and most prominent public viewpoints located approximately a ½-mile, one (1) mile, and two (2) miles from the proposed facility. An accompanying map should show where each photo was taken. Below, please describe how the proposed facility will be compatible with the existing setting.8 If the facility is proposed on a building or a pole (other than an existing wireless communication facility) simulations from the most prominent public viewpoint must be provided along with simulations showing all elements of the project shown in one or more close-in photo simulations. Also describe below how the facility would blend with architectural features.9 (Attach simulations and additional pages if needed.)

III.D.2. Visual Impact Analysis for a Non-Stealth Facility: Please describe the “before” and “after”photosimulation submittals, which should be based on the closest and most-prominent public viewpoints located approximately a ½-mile, one (1) mile, and two (2) miles from the proposed facility, with an accompanying map showing where each photo was taken. Indicate in each simulation, the maximum potential structural envelope for physical modifications pursuant to Section 6409(a), and describe below whether the modification would cause the facility to become prominently visible from a public viewpoint.10 (Attach simulations and additional pages if needed.)

7 See the definition of “Wireless Communication Facility, Stealth” in the NCZO and CZO for examples. 8 See NCZO Sec. 8107-45.4(c) or CZO Sec. 8175-5.20.3(c) 9 See the development standards in NCZO Sec. 8107-45.4 or CZO Sec. 8175-5.20.3 10 See https://www.vcrma.org/wireless-communication-facility-section-6409-a-modification for a summary of the federal law.

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III.D.3 Propagation Diagrams: Propagation diagrams may be required for any wireless communication facility,and if the proposed facility would include any of the following characteristics, then propagation diagrams shall be submitted:

• It will exceed 40 feet in height and would be located in the non-coastal zone, or if will exceed 30 feet inheight in the coastal zone;

• It could exceed the 40-foot height limit of an Area Plan after a Section 6409(a) Modification;• It is proposed to be located on a ridgeline;• It is proposed within a Scenic Resource Area or the Santa Monica Mountains overlay zone;• It is proposed in, or within 300 feet of, an Urban Residential Zone, or• It is proposed to be located in, or within the designated buffer for, Environmentally Sensitive Habitat Area

(ESHA), or anywhere within the Santa Monica Mountains Overlay Zone.• It will be visible from a designated or eligible State or County Scenic Highway, and it will be visible from

any public viewing area in the coastal zone.

The propagation diagrams shall consist of a set maps showing each of the following: (1) the location of the provider’s existing facilities, and existing coverage or capacity area; (2) the coverage or capacity area at proposed antenna height; and (3) the coverage or capacity area at consecutively 10-foot lower increments between the proposed height, down to 40 feet in height (30 feet in height if located in the coastal zone). Below, please provide a brief description of why the wireless communication facility modeled in the propagation diagrams would or would not meet service objectives.11 (Attach propagation diagrams and additional pages if needed.)

11 If capacity cannot be illustrated on a map, an engineering report may be submitted for review by the County or the County’s consultant. Additional types of analyses may be required to demonstrate the need for a facility height to achieve a line-of-sight connection in view of potential obstructions such as buildings, topography, or vegetation. See NCZO Sec. 8107-45.3(b) or CZO Sec. 8175-5.20.10(i) for additional guidance.

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III.E. Assessor Parcel Numbers (“APNs”) and Project Site Location

C.1. Please list all of the APNs that constitute the project site:

(Attach additional sheets if necessary)

C.2. Street Address (if any):

C.3. Carrier Identification Site Name or Number:

C.4. Latitude and Longitude coordinates for facility location:

C.5. Community (e.g., Piru, Oak Park):

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III.F. Primary Contact InformationPlease designate and provide the following information about the person who will serve as the primary point of contact on this project. All project-related correspondence will be directed to this person.

Name: Phone Number:

Mailing Address:

Email Address: Fax Number:

III.G. Applicant, Property Owner, Wireless Carrier, and Consultant Information Please provide the following information about the applicant, property owner, and all consultants (e.g., architects, civil engineers, surveyors, and permit expediters) who prepared the application materials (e.g., plans, reports, and studies). For the person designated as the primary contact (Item F, above), please state: “Same as Primary Contact.” If the item does not apply to your project, please check the “N/A” box and proceed to the following item. N/A

G.1. Applicant The applicant is: (Please check the appropriate box.)

Owner Lessee Has Power of Attorney Authorized by Owner

If the applicant is not the property owner(s), please submit a lease agreement, power of attorney document, or owner authorization document with your application.

Name: Phone Number:

Mailing Address:

Email Address: Fax Number:

I hereby submit an application for the land use entitlement(s) identified in this application questionnaire, and certify that the information and exhibits submitted herewith are true and correct to the best of my knowledge.

I certify that I have read and understand all of the instructions and submittal requirements for my application package and have made a good faith effort to comply with these instructions and to provide all of the materials and information that are required for a complete application.

I hereby acknowledge that I have been informed of my right to make a written request to the County to receive notice of any proposal by the County to adopt or amend a general or specific plan, or a zoning ordinance or other ordinance affecting building or grading permits, prior to action on said item.

I certify that I am aware that the information provided in my application package may be subject to public inspection that occurs as a result of any request made in accordance with the requirements of the California Government Code [§6253(a) et seq].

Applicant’s Signature Date

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G.2. Property Owner If the property owner is the same as the applicant (Item G.1, above), write “same.” If there is more than one property owner, please submit a consent letter for each additional property owner. If the property owner refuses or is unable to sign, please provide a copy of the lease, title report, or other documentation.

Name: Phone Number:

Mailing Address:

Email Address: Fax Number:

Property Owner’s Signature Date

G.3. Wireless Carrier

Company/Organization:

Contact Name: Phone Number:

Mailing Address:

Email Address: Fax Number:

G.4. Land Use Consultant

Name: Phone Number:

Mailing Address:

Email Address: Fax Number:

G.5. Civil Engineer

Name: Phone Number:

Mailing Address:

Email Address: Fax Number:

G.6. Licensed Land Surveyor

Name: Phone Number:

Mailing Address:

Email Address: Fax Number:

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G.7. Radio Frequency Engineer

Name: Phone Number:

Mailing Address:

Email Address: Fax Number:

COUNTY OF VENTURA

AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF

I hereby authorize the person identified below to act as my agent to apply for, sign, and file the documents necessary to obtain the permits required for my project (excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility). My agent should receive copies of all notices and communications related to my project unless I have otherwise notified the County.

Project Description: _____________________________________________________________ _____________________________________________________________

(Include Permit # if available) Project Location: ________________________________________________________________

________________________________________________________________ (Address, APN, Carrier Identification Site Name or Number)

Name of Authorized Agent: ________________________________________________________ (Please Print)

Address of Authorized Agent: ______________________________________________________

Phone Number of Authorized Agent: ________________________________________________

E-Mail Address of Authorized Agent: ________________________________________________

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COUNTY OF VENTURA PROPERTY OWNER ACKNOWLEDGEMENT

I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Further, I agree that I and my agent will abide by all ordinances of the County of Ventura and that any approvals granted for this project will be carried out in accordance with the requirements of the County of Ventura.

Property Owner’s Name: _________________________________________________________ (Please Print)

Property Owner's Signature: ________________________________ Date: _________________

Property Owner’s E-Mail Address: __________________________________________________

Property Owner’s Phone Number: __________________________________________________

Note: A copy of the owner's driver's license, notarization, or other verification acceptable to the agency must be submitted with this form to verify property owner's signature. The owner must be as shown on the latest Assessor records.

Verification of Property Owner Signature: Driver License Notarized Letter Other

Staff Signature Date

AUTHORIZATION OF AGENT TO ACT ON PERMITTEE'S BEHALF*

I hereby authorize the person identified below to act as my agent to apply for, sign, and file the documents necessary to obtain the permits required for my project. My agent shall receive copies of all notices and communications related to my project unless I have otherwise notified the County.

Project Description: ______________________________________________________________

______________________________________________________________ (Brief Summary to Include Permit No., If Available)

Project Location: _________________________________________________________________

_________________________________________________________________ (Address, APN and other property identification as needed)

Name of Authorized Agent: _________________________________________________________ (Please Print)

Address of Authorized Agent: _______________________________________________________

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Phone Number of Authorized Agent: _________________________________________________

E-Mail Address of Authorized Agent: _________________________________________________

* A notarized letter from the permittee may be submitted in lieu of this form.

PERMITTEE ACKNOWLEDGEMENT I declare under penalty of perjury that I am the permittee for the project at the address listed above, and I personally filled out the above information and certify its accuracy. Further, I agree that I and my agent will abide by all ordinances of the County of Ventura and that any approvals granted for this project will be carried out in accordance with the requirements of the County of Ventura.

Permittee’s Name: ______________________________________________________________ (Please Print)

Permittee's Signature: ________________________________ Date: ______________________

Permittee’s E-Mail Address: _______________________________________________________

Permittee’s Phone Number: _______________________________________________________

COUNTY OF VENTURAWireless Communication Facility

Consent to Future Collocation

I hereby authorize the County of Ventura to provide my contact information to other wireless communication facility carriers who may be interested in collocation on the wireless communication facility identified in this application. This information will only be provided when a new facility is proposed within the vicinity of the wireless communication facility identified in this application (pending approval of this application).

Collocation Opportunity Description: ______________________________________________________________ ______________________________________________________________ (Brief summary may list applicable radio frequencies and include a description of the facility design)

Project Location: _________________________________________________________________

_________________________________________________________________ (Address, APN, Lat./Long. and other property identification as needed)

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Name of Authorized Agent: _________________________________________________________ (Please Print)

Address of Authorized Agent: _______________________________________________________

Phone Number of Authorized Agent: _________________________________________________

E-Mail Address of Authorized Agent: _________________________________________________

III.H. Project DescriptionTo ensure County staff understands your project and to avoid delays in processing your application, it is very important to provide as much information as possible on all aspects of the proposed project. In order to present a detailed project description, please answer all of the following questions and provide the requested materials (as applicable) to supplement the project information that must be shown on the project plans and/or map.12

H.1. Legal Lot Requirement Has the Planning Division issued a Preliminary Legal Lot Determination for the property? Yes No

a. If the answer above is “no,” please proceed to Item H.1.b. If the answer is “yes,” what was the finding of thePreliminary Legal Lot Determination?

b. If the Planning Division has not issued a Preliminary Legal Lot Determination for the property, please describeby what means (e.g, Tract Map, Parcel Map, Parcel Map Waiver, or Certificate of Compliance) the propertygained its current configuration, making sure to include the map citation (e.g., “8 MR 14 36 PM 4”) or projectcase number (e.g., “PMW 1046” or “SD06-0031”). However, if the Planning Division has not issued aPreliminary Legal Lot Determination for the property, and you do not have information on the means by whichthe property gained its configuration, please submit an application for a Preliminary Legal Lot Determinationprior to submitting an application for your project.13 If the project does not require a Preliminary Legal LotDetermination, please check the “N/A” box. N/A

H.2. Entitlements and/or Approvals

a. Existing Permits: List all Federal, State, or Ventura County permits which currently are in effect for thebuildings, structures, and uses that currently exist on the project site. If Zoning and Building Permits areunavailable for a building or structure, please contact the Tax Assessor’s Office to determine when thebuilding or structure was constructed and provide the date. If there are no permits currently in effect on theproject site, please check the “N/A” box and proceed to Item H.2.b. N/A

12 See the “Requirements for Discretionary Entitlement Application Plans, Subdivision Maps, and Parcel Map Waiver Sketch Maps” checklist for the information that must be shown on project plans and/or the map. Please note that a detailed, narrative project description may be submitted with—but not in lieu of—a completed application questionnaire. 13 For more information on how to determine if a project site would be located on a legal lot, and for Preliminary Legal Lot Determination applications, please see http://vcpublicworks.org/general/county-surveyor-legal-lot-determination.

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Agency Permit Case

Number Description of Permitted Use/Development

Permit Issuance

Date

Permit Expiration

Date

b. Requested Permits, Actions, and Approvals: List and describe all of the Planning Division, other CountyAgencies, responsible agencies, and trustee agencies permits, actions, and approvals that you arerequesting in order to implement the proposed project.14 If the project involves a modification to anypreviously approved permit (e.g., local, State, or Federal permit), please list and describe the previouslyapproved permit (e.g., type of permit and permit number).

Agency Permit Case

Number Description of Permit

Permit Issuance

Date

Permit Expiration

Date

c. Previous Modifications (for existing facilities only):(1) Was the wireless communication facility constructed prior to February 22, 2012? Yes No

(2) If the project involves a modification to any previously approved permit, please list and describe each modification (e.g., type of permit and permit number).

Agency Permit Case

Number Description of Modification

Permit Issuance

Date

Permit Expiration

Date

14 For a definition of “responsible” and “trustee” agencies, please see the State CEQA Guidelines [California Code of Regulations, Title 14, Chapter 3, §15381 and §15386].

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d. Zoning Violations:

(1) Is the project site currently subject to any Federal, State, or Ventura County violations? Yes NoIf so, please list and describe the violation:

Agency Violation Case Number Description of the Violation

(2) If the project is being proposed in order to abate a Zoning Violation, please describe how the proposed project would abate the Zoning Violation. For projects that do not involve a Zoning Violation, please check the “N/A” box and proceed to Item H.3. N/A

H.3. Self-Imposed Restrictions

a. Existing Restrictive Covenants: Is the property (or a portion thereof) subject to a Restrictive Covenant?Yes No

If the answer is “Yes,” please submit a copy of the Restrictive Covenant.

b. Please describe any features that have been incorporated into the project description to avoid any adverseenvironmental impacts and/or to achieve consistency with a policy or regulation that applies to the project(e.g., self-imposed prohibitions on future ministerial uses of the property). If the project includes a restrictivecovenant, please describe the following features of the restrictive covenant:• The purpose of the restrictive covenant (e.g., avoidance of a significant impact to biological resources or

geological hazards);• The type of areas that would be subject to the restrictive covenant (e.g., wildlife habitat areas located

adjacent to the project site); and,• The amount of area that would be subject to the restrictive covenant.

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H.4. Dedications/Easements Please describe in detail the type, size, and purpose of all proposed dedications (e.g., road, utility, or habitat conservation easements). For projects which do not have any dedications or easements, please check the “N/A” box and proceed to Item H.5. N/A

H.5. Water Supply Please complete this section if water for landscaping or fire suppression systems is proposed for the wireless communication facility. For projects which do not need water for landscaping or fire suppression systems, please check the “N/A” box and proceed to Item H.6. N/A

b. What is the existing source of water for the landscaping? Please check the item that applies and, if a waterpurveyor provides water, please provide the requested information about the water purveyor:15

(1) Water Purveyor’s Name:

(2) Individual Water Well

(3) Shared Water Well

(4) On-site Storage or Stormwater Cistern

c. What is the size of the water tank/reservoir that serves the project site? gallons

d. Please provide a detailed description of the proposed water source for fire protection purposes, by answeringthe following questions and providing the following information:

(1) Is the source of water for fire protection purposes going to be provided by a private well or purveyor? Private Well Purveyor

If water is going to be provided by a purveyor, please provide the following information. If water is not going to be provided by a private well, please proceed to Item H.5.d(1)(b).

(a) Purveyor Name:

Address:

Phone Number:

15 In order to identify the water purveyor that serves the project site, please see the Watershed Protection District’s “Inventory of Public and Private Water Purveyors in Ventura County” (March 2006) which is available at the Watershed Protection District, Groundwater Section.

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(b) Size of the water tank/reservoir that serves the water system: gallons

(c) Fire flow that is available at 20 PSI-R from the water system at the nearest fire hydrant to the project site: gpm

H.6. Surface Water QualityThe following questionnaire will only determine if the proposed project is subject to Ventura Countywide NPDES Municipal Stormwater Permit Order No. R4-2010-0108, Part 4.E “Planning and Land Development Program” requirements to select, design, construct, and maintain Post-construction Stormwater (PCSW) controls. Additional evaluation of the proposed project will be conducted to determine any additional individual and cumulative impacts by the proposed project to surface water quality.

a. Is this application for a new wireless communication facility that will result in creation or addition of more than5,000 square feet of impervious surface area?16

Yes, proceed to item H.6.b No, proceed to item H.6.c

b. Is the project located in or directly adjacent to, or discharging directly to an Environmentally Sensitive Area17

(ESA), where the development will: A) Discharge storm water runoff that is likely to impact a sensitive biological species or habitat; andB) Create 2,500 square feet or more of impervious surface area (refer to the Definition below).

No, none of the above; this proposed New Development project is not subject to PCSW Controls.

If you check “Yes” in at least one box above (item H.6.a or H.6.b), proceed to item H.6.c for required project submittal information, otherwise proceed to H.7.

c. Is proposed redevelopment and land-disturbing activity (not maintenance) a project that will result in creation,addition, or replacement of 5,000 square feet of impervious surface area (refer to the Definition below) onan already developed site18? Yes, the PCSW controls are required; for project submittal information refer to item H.6.d No, this redevelopment project is not subject to PCSW controls.

d. If you answered “YES” to question H.6.c, the proposed project is subject to design, construction, andmaintenance of the PCSW controls in accordance with the Ventura Countywide Technical Guidance Manual

16 If the creation or addition of impervious surfaces is 50% or more of the existing impervious surface area, then stormwater runoff from the entire area (existing and additions) must be considered for purpose of stormwater mitigation. If the creation or addition is less than 50% of the existing impervious area, then stormwater runoff from only the addition area needs mitigation. “Impervious Surface Area” is defined as a hard surface area which either prevents or retards the entry of water into the predevelopment soil mantle. Common impervious surfaces include, but are not limited to, roof tops, walkways, patios, driveways, parking lots or storage areas, impermeable concrete or asphalt paving, compact gravel roads, packed earthen materials, and oiled macadam or other surfaces which similarly impede the natural infiltration of stormwater. For complete definition refer to the 2011 Ventura Countywide Technical Guidance Manual for Stormwater Quality Control Measures available at http://www.vcstormwater.org/index.php/publications/manuals/tech-guide-manual. 17 For complete ESA information, call the Water Quality Compliance Manager at (805) 662-6737. 18 For additional information, call the Water Quality Compliance Manager at (805) 662-6737.

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(TGM) for Stormwater Quality Control Measures. The following items shall be included in your application package:

I. Identify proposed PCSW controls on your site/grading plan,

II. Provide the necessary analysis in your Drainage Study to demonstrate that the PCSW controls willfunction as proposed including any applicable stormwater quality design flow or volume calculationsfor proposed treatment device(s) using applicable “Design Procedure Form” (Appendix G of theTechnical Guidance Manual), and

III. Submit a Post-Construction Stormwater Management Plan (PCSWMP)19.

For more information refer to http://onestoppermit.ventura.org under Surface Water Quality Section or call Water Quality Engineer at (805) 662-6737.

The copy of the Ventura Countywide Technical Guidance Manual (TGM) for Stormwater Quality Control Measures is available at http://www.vcstormwater.org/index.php/publications/manuals/tech-guide-manual.

H.7. Floodplain Management20 a. If the project, including any site grading, is proposed to be located within a 100-year floodplain but the

floodplain boundaries and 100-year base flood elevation on the property have not been determined by FEMA on the Flood Insurance Rate Map (i.e., referred to as an Unnumbered/Approximate ‘A’ flood zone), a California-licensed Civil Engineer will need to submit hydrologic and hydraulic analyses that determine the boundaries, base flood elevation, and velocity of the 100-year floodplain and, if applicable, the Regulatory Floodway. A California-licensed Land Surveyor can provide current topography of the property as part of the submitted engineering analyses. If the project is not located within an Unnumbered/Approximate ‘A’ flood zone, please check the “N/A” box and proceed to Item H.7.b. N/A

b. If the project, including site grading, is proposed to be located in close proximity to a boundary of a RegulatoryFloodway or a boundary of a 100-year floodplain, as delineated on the current (‘Effective’) or latest FEMA-issued (‘Preliminary’) Flood Insurance Rate Map, a California-licensed Civil Engineer, Architect, or LandSurveyor will need to submit a scaled site plan, using current topography, verifying the location of theproposed project in relation to the floodway/floodplain boundary. Please proceed to H.7.c; however, if theproject is not located within a floodway/floodplain, please check the “N/A” box and proceed to Item H.7.d.N/A

c. If the project is proposed to be located within a 100-year floodplain, please list all proposed structures,describe the site grading, and list any new or replacement utilities and services (electrical, mechanical,heating, ventilation, plumbing). Please proceed to H.7.d.

19 County of Ventura PCSWMP form is available at http://onestoppermit.ventura.org under Surface Water Quality Section’s “Forms” tab. For additional information, call the Water Quality Engineer at (805) 662-6737.

20 County of Ventura Floodplain Management Ordinance, Title 44 Code of Federal Regulations Sections 59, 60, 65, and 70.

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d. If the project is proposed to be located within the Silver Strand or Hollywood Beach coastal communities,specifically, please provide the following elevation information.21 If the project is not located within thesecommunities, please check the “N/A” box. N/A

(1) Elevation (Mean Sea Level) of the localized flooding spillpoint for the subject property: msl.

(2) Elevation (Mean Sea Level) of the crown of fronting street (measurement taken at mid-point of theproperty frontage): msl.

H.8. Geology, Site Grading, and Drainage a. If the project involves site grading activities, please provide the following information. For projects that do

not involve grading activities, please check the “N/A” box and proceed to Item H.8.b. Please be advised that all projects involving new construction require the submission of three copies of a soils report. N/A

(1) Please provide the following statistics on the proposed site grading activities:

(a) Area to be graded: sq. ft. acres

(b) Slope ratio of steepest finished slope (horizontal feet/each vertical foot):

(c) Height of highest finished slope (from top to bottom): ft.

(d) Please state whether or not the graded soil is proposed to be balanced on-site during construction, or proposed to be reused during the landscaping phase of the project.

(e) If the proposed project would result in the export of materials, please provide the following information. If the project does not involve the export of materials, please check the “N/A” box and proceed to Item H.8.a(1)(f). N/A

(i) Types of materials to be exported:

(ii) Location to which excess materials would be transported:

(iii) Proposed truck route to the location where the materials would be transported:

21 Please see the Public Works Public Information Counter to obtain an instruction handout.

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(f) If the proposed project would require the import of materials, please provide the following information. If the project does not involve the import of materials, please check the “N/A” box and proceed to Item H.8.a(1)(g). N/A

(i) Types of materials to be imported:

(ii) Location from which the materials would be imported:

(iii) Proposed truck route from the materials site to the proposed project site:

(g) For all projects involving new construction or grading activities, please submit three copies of a soils report. If the project does not involve new construction or grading activities, please check the “N/A” box and proceed to Item H.8.a(1)(h). N/A

(h) For all projects involving new construction or grading and that are located within a hillside or Geologic Hazard Area, please submit three copies of a geology report. If the project does not involve new construction or grading in any of these areas, please check the “N/A” box and proceed to Item H.8.a(1)(i). N/A

(i) Please describe any features that have been included in the project description to control the creation of dust.

b. Please submit four copies of a drainage study, if the project would result in any of the following: a changein the amount of impervious area within the project site; any change on local drainage patterns; and/or anyadditional storm water runoff onto adjacent property or public roads. If the project does not require a drainagestudy, please check the “N/A” box and proceed to Item H.9. N/A

The drainage study must conform to the following requirements and must include (but is not limited to) thefollowing information:

(1) The drainage study must be prepared, signed, and stamped by a California Registered Civil Engineer.

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(2) The drainage study must conform to the Ventura County Road Standards, as well as the Watershed Protection District’s standard, which is that there must not be an increase in peak runoff rate in any storm frequency.22

(3) The drainage study must:

(a) Calculate and address the potential increase in the peak runoff rate that would be generated by the proposed project;

(b) Describe all proposed and existing drainage facilities;

(c) Identify if the project would generate additional storm water run-off onto adjacent private property or any public road right-of-way;

(d) Identify if the drainage from the project site would be directed or tie into the existing storm drain facilities/ditches;

(e) Identify if the project would result in any change on local drainage patterns; and,

(f) Identify if the capacity of the existing local drainage facility is adequate to accept the peak runoff created by the project.

(4) The drainage study must include all hydrology and hydraulic calculations used in preparing the drainage plan. The hydrology and hydraulic calculations must be prepared according to the Ventura County Flood Control District Hydrology Manual and the Ventura County Public Works Agency, Transportation Department’s, Road Standards.23

H.9. Hazardous Materials/Waste and Fire Protection a. Please submit a completed “Certification Statement of Hazardous Waste/Substance Site” which is

included near the end of this application packet.

b. Please describe the type and quantity of hazardous materials (e.g., fuel, batteries, paints, fertilizers, orchemicals) and wastes utilized and/or stored on-site, by completing the following table:

Hazardous Material or Waste DOT Hazard Classification

IBC/IFC Hazard Class

Largest Container/

Tank (ft3, lbs., or gal.)

Total Amount

(ft3, lbs., or gal.)

22 For a checklist of the requirements for drainage studies, please see the Watershed Protection District’s “Guide for Hydrologic and Hydraulic Study Reports,” which is available at http://pwaportal.ventura.org/WPD/dept/WPD/divisions/planning_regulatory/docs/Guide%20for%20Hydra.pdf, and the Ventura County Road Standards, which are available at the Transportation Department Public Counter. 23 Please check the Transportation Department Requirements for drainage study submittals. A checklist of requirements may be obtained from the Public Counter.

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c. Please describe any underground hazardous materials storage tank(s) that are proposed to be installed,removed, and/or used. If the project is located on an active Leaking Underground Fuel Tank (LUFT) site,please describe the status of the case. If the project site does not have an underground hazardous materialsstorage tank or involves a LUFT site, please check the “N/A” box and proceed to Item H.10.N/A

H.10. Noise

a. Existing Noise Environment: Please describe the sources of noise surrounding the project site bycompleting the following table. A noise study may be submitted in lieu of providing the informationrequested below.24

Noise Source (e.g., Railway or Roadway) Approximate Distance Between the Source of the Noise and the Project Site (feet)

b. Please describe the noise that would be generated by the proposed project, as well as noise to whichproposed uses would be subject, by providing the following information.25

(1) Noise Sensitive Uses:

(a) Does the project involve the use of dwellings, schools, hospitals, nursing homes, churches, or libraries? Yes No If the answer is yes, please proceed to Item H.10.b(1)(b). If the answer is no, please proceed to Item “Noise Generating Activities” in H.10.b(2).

(b) Is the project site located:

24 See Footnote 16 (above). 25 For the definitions, measurement, and thresholds/standards relating to noise, please see the: Ventura County General Plan Goals, Policies and Programs (2008, §2.16), which is available on-line at http://docs.vcrma.org/images/pdf/planning/plans/Goals-Policies-and-Programs.pdf; Ventura County General Plan Hazards Appendix (2005, §2.16), which is available on-line at http://docs.vcrma.org/images/pdf/planning/plans/General_Plan_Hazards_Appendix.pdf; and/or, Ventura County Initial Study Assessment Guidelines (February 2011, Section 19, “Noise and Vibration”), which are available on-line at https://www.vcrma.org/ceqa-implementation-and-initial-study-assessment-guidelines.

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(1) Within a noise contour that identifies areas with ambient noise levels that are 60 db(A) CNEL or greater, surrounding a roadway or airport?26 Yes No

If the answer is yes, please submit a noise study that complies with the requirements of the Ventura County Initial Study Assessment Guidelines.

(2) Within 500 feet of a railroad, industrially designated area, or other relatively continuous noise source?27 Yes No

If the answer is yes, please submit a noise study that complies with the requirements of the Ventura County Initial Study Assessment Guidelines.

(2) Noise-Generating Activities:

Noise-Sensitive Use Typical Noise-Sensitive Time Period

Does the project involve the use of noise-generating equipment, vehicles, or

machinery within 500’ of the noise sensitive use during the typical noise-sensitive

time period(s)?* Hospital or Nursing Home 24 hours Yes No Single-Family or Multi-Family Dwelling 7:00 PM to 7:00 AM, Monday

through Friday; and, 7:00 PM to 9:00 AM, Saturday, Sunday, and Local Holidays

Yes No

School, Church, or Library Anytime when in operation. Yes No * When answering this question, please consider all phases of the project (e.g., vegetation removal, grading, construction,and long-term operational phases of the project).

If the answer is yes to any of the items above, please submit a noise study that complies with the requirements of the Ventura County Initial Study Assessment Guidelines and/or County of Ventura Construction Noise Threshold Criteria and Control Measures (as applicable).

Alternatively, you may forego the preparation of a noise study, if you are willing to accept a condition on the entitlement that will prohibit the noise-generating activities during the typical noise-sensitive time period(s) for the noise-sensitive use(s). If you would like to forego the preparation of a noise study by accepting the condition that will limit the time periods when the noise-generating activities may occur, please check the following box.

26 See the Ventura County General Plan Hazards Appendix (2005, §2.16), or consult the Permit Intake Coordinator for maps that identify the locations of the noise contour lines that indicate areas around roadways and airports within Ventura County, which experience noise levels that are at least 60 dB(A) CNEL. 27 See the Ventura County General Plan Land Use, Existing Community, and Area Plan Maps (as appropriate) to determine the project site’s proximity to industrially-designated areas. Links to the Ventura County General Plan Land Use, Existing Community, and Area Plan Maps are available on-line at https://www.vcrma.org/ventura-county-general-plan.

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a. Utilities: Please identify all of the utilities that would provide service to the project site, by completing thefollowing table:

Utility Name Address Phone Number Email Address

Electricity

Fiber Optic Cable

Natural Gas

Telephone

b. Electricity:

(1) What is the projected amount of electrical usage (peak KW/Hours/Day)?

(2) Do existing lines have to be increased in number or size? Yes No If yes, please describe:

(3) Do overhead electrical facilities require relocation or under grounding? Yes No If yes, please describe:

(4) Please describe the length of new offsite electrical transmission and distribution facilities that are required to serve project. If the project does not involve the installation of new offsite electrical transmission and distribution facilities, please check the “N/A” check box and proceed to Item H.11.c. N/A

c. Natural Gas:

(1) Please indicate the expected amount of gas usage:

(2) Do existing gas lines have to be increased in size? Yes No If yes, please describe:

(3) Do existing gas lines require relocation? Yes No If yes, please describe:

(4) Please describe the length and size of new offsite gas mains that are required to serve the project. If the project does not involve the installation of new offsite gas mains, please check the “N/A” box and proceed to Item H.12. N/A

H.11. Utilities

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H.12. Agricultural Resources For projects located within rural-, agricultural-, and open space-designated areas, please provide the following information. For all other projects, please check the “N/A” box and proceed to Item H.12. N/A

a. Important Farmland Inventory: Please list the amounts of classified farmland28 that will be covered bypermanent pavement or permanent flooring as a result of the proposed project.

(1) Prime Farmland sq. ft.

(2) Statewide Importance Farmland sq. ft.

(3) Unique Farmland sq. ft.

(4) Locally Important Farmland sq. ft.

b. Please describe how the project's design will minimize the loss of agricultural soils.

c. For purposes of land use compatibility, the distance from new structures, as well as outdoor uses, to the lotlines adjacent to neighboring farmland will be measured and evaluated. Please contact the Agricultural LandUse Planner ([email protected] or (805) 933-2926) for details.

d. Is the property subject to an LCA Contract? Yes No

If the answer is “No,” please proceed to Item H.13. If the answer is “Yes,” please provide the LCA ContractNumber:

28 Information on the amount of classified farmland located on the project site may be obtained from the Resource Management Agency GIS Department. Please contact Mr. Jose Moreno, M.A., GISP, GIS Supervisor, at (805) 477-1585, or [email protected], to obtain this information.

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H.13. Air Quality

a. Air Emissions: Please provide the following information on known sources of air emissions surrounding theproject site (e.g. manufacturing, industrial, herbicide applications, and roadways).

(1) Air Emission Source(s):

(2) Approximate distance between the emissions source and the project site: feet

b. Air Pollution Emitting Devices: Please indicate if any equipment or devices associated with the project willrelease air emissions that may require an Air Pollution Control District (“APCD”) Permit to Operate or anAPCD Permit to Construct.29 If the project does not require either of these APCD Permits, please check the“N/A” box and proceed to Item H.14. N/A

H.14. Wireless Communication Facility Operational Characteristics

a. Existing Operations: For project sites that are currently developed with one or more wireless communicationfacilities, please provide the following information. For all other projects, please check the “N/A” box andproceed to Item H.14.b. N/A

(1) Is there a master Conditional Use Permit for the wireless facilities on the site? Yes No

(2) Describe which resources the proposed wireless communication facility will share with existing facilities (e.g. utility lines, access roads, water source, screening devices)?

(3) Are existing wireless communication facilities on the site designed to blend with the surrounding environment through siting and design? If yes, please describe the design, size, color, and setting of the existing facilities. Yes No

29 Please see APCD Rule 10, Permits Required, which is available on-line at: http://www.arb.ca.gov/DRDB/VEN/CURHTML/R10.PDF.

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b. Light, Glare, and Heat: Please describe any uses, operations, or structures that would produce light, glare, orheat, as well as any methods that would be used to shield, enclose, or otherwise control the light, glare, orheat. If the project would not produce light, glare, or heat, please check the “N/A” box and proceed to ItemH.14.c. N/A

c. FCC Information: Please provide the Federal Communications Commission Lease Agreement number orFederal registration Number FRN number.

Lease Agreement Number: FRN Number:

d. Vehicle Trips: Please provide the number of vehicle trips to the facility per month, the average length of eachvehicle trip, the total monthly vehicle miles traveled, and the type(s) of vehicle which will be used.

e. Maintenance Activities: Please complete the following table describing the type, frequency, and duration ofmaintenance activities. Including how often backup battery systems, and fuel-powered back-up generators,and cooling systems will be tested per month.

System Type # of Tests per Month Average Duration of Test (min.)

H.15. Existing Physical Features and Development on, and Surrounding, the Project Site

a. Please describe the physical features of the project site. Physical features that should be included, but arenot limited to:

• Creeks, streams, drainage facilities, drainage patterns, and all other types of wetlands.

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• Distinctive topographical and/or scenic features, such as the Pacific Ocean, ridgelines, mountain ranges,hillsides, and Geologic Hazards Areas.30

• Wildlife habitat (e.g., woodlands or chaparral habitat).

b. For project sites that are located within rural-, agricultural-, or open space-designated areas, please describethe agricultural activities that exist on-site (e.g., types of crops that are cultivated and/or animal keeping orhusbandry activities that occur). For projects that are not located within these areas, please check the “N/A”box and proceed to Item H.15.c. N/A

c. Please describe the physical features surrounding the project site. Please include the following physicalfeatures and indicate where they are located in relation to the project site [e.g., direction (north, south, east,or west) in relation to, and distance from, the project site]:

• Creeks, streams, drainage facilities, drainage patterns, and all other types of wetlands.• Distinctive topographical and/or scenic features, such as the Pacific Ocean, mountain ranges, and

hillsides.• Wildlife habitat (e.g., woodlands or chaparral habitat).• Local access to the project site including (but not limited to) County and city roadways, as well as private

roadways or driveways.• Regional access to the project site, which typically consists of State and Federal freeways and highways.

d. For sites with existing commercial businesses on the property, please provide the days and hours of operationof each business located on the property.

e. For sites with employees who work on the property, please describe the days and hours that they work, aswell as the number of employees/shift.

30 To determine if the project site is located within a Geologic Hazards Area, please see the Ventura County General Plan Hazards Appendix (Last Amended on November 15, 2005, Chapters 2.2 through 2.5), which is available on-line at: http://docs.vcrma.org/images/pdf/planning/plans/General_Plan_Hazards_Appendix.pdf

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f. For facilities on sites with multi-tenant buildings and structures, please provide the number of tenants thatexist on the subject property. For project sites that do not have multi-tenant buildings and structures, pleasecheck the “N/A” box and proceed to Item H.15.g. N/A

g. Will the wireless communication facility have any employees or visitors on a daily basis? If “yes” pleasedescribe. Yes No

h. Please describe the existing development on adjacent properties surrounding the project site by completingthe following table. Please describe the types of uses (e.g., agriculture, residential, recreation, openspace/vacant, retail sales, wholesale, multi-tenant office space, or manufacturing and assembly plant),buildings, and structures on properties that are adjacent to, or across a roadway from, the subject property.

Direction Building, Structure, or Outdoor Use Use(s)

Approximate Height or

Number of Stories

Proximity to the Proposed Project

(feet)

North

South

East

West

i. For wireless communication facilities which are proposed on the same site as a hotel/motel, school/daycare,hospitals, or elderly development/care facilities, please indicate the proposed number of each of the following.For projects that are not near these types of uses/facilities, please check the “N/A” box and proceed to ItemH.15.j. N/A

Use (Name of motel,

school, etc.) Rooms in the

building Guests Staff Students

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j. Please answer the following questions related to Military Operation Areas. 39

(1) Is your project within 1,000 feet of a military installation?

Yes No

(2) Is your project beneath a low-level “military training route” flight path?

Yes No

(3) Is your project within a special use “restricted” airspace?

Yes No

H.16. Cultural Resources a. Has the project site been subject to any archaeological, historical, and/or paleontological resource surveys?

Yes No Unknown

b. Is there a building or structure that is 50 years old or older that will be demolished or otherwise impacted bythe proposed development?

Yes No Unknown

If the project has been subject to an archaeological, historical, and/or paleontological resource survey, please submit a copy of the report or any documentation regarding the survey as part of your application. Please be advised that:

• If it is found that the project site is located on, or within the vicinity of, known archaeological, historical, and/orpaleontological resources, or has not been previously surveyed for the presence of these resources, ananalysis of potential impacts to the resources might be required as part of the environmental review of yourproject;

• Typically all project sites that are Designated Cultural Heritage Sites31 will require an analysis of potentialimpacts to the cultural resources as part of the environmental review of your project; and,

• Buildings or structures that are at least 50 years old might qualify as historical resources, the impacts to which

31 Please contact the Planning Division Counter or the Permit Intake Coordinator to determine if the project site qualifies as a Designated Cultural Heritage Site. You will need to present the Assessor’s Parcel Number (APN) to the Planning Counter staff or the Permit Intake Coordinator to obtain this information. 39 In accordance with State Senate Bill 1462, please respond to these questions by visiting the County of Ventura’s public mapping tool “County View,” located at http://gis.ventura.org/countyview. Once you have located your project’s appropriate parcel, click “Parcel Report.” Once the Parcel Report opens, scroll down to “Hazards” to find the subsection titled “Military Operations Area.” The information presented in the Parcel Report will assist you in answering the questions.

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are required to be analyzed as part of the environmental review of the project.

H.17. Biological Resources a. Has an Initial Study Biological Assessment been conducted by a Qualified Biologist for this project?

Yes No

If No, be advised that all projects that could impact sensitive biological resources must provide an Initial Study Biological Assessment (ISBA) with the project application. This includes projects located-on or adjacent-to land with native vegetation, on land within 300 feet of watercourses or wetlands, on land used by animals for movement between habitats, or on land that provides other habitat for sensitive species. Discuss your specific project with the Planning Division staff to determine if an ISBA will be required.

H. 18. Protected Trees Will any trees protected by the Ventura County Tree Protection Ordinance be potentially impacted by this project?

Yes No

Note: Potentially impacted trees include not only the protected trees that are directly part of this request, but also any other protected trees whose tree protection zones (TPZs) are within 20 feet the limits of the construction area (including access drives and utility easements). This includes trees growing on adjacent parcels if their TPZ extends onto the subject parcel. The TPZ is defined through whichever of the following calculation results in the largest area of protection:

• The area that extends out from the trunk to 5 feet beyond the dripline,• The area measured from 15 feet distance from the trunk, or• The area resulting from multiplication of the tree trunk diameter in inches, by one and a half feet (i.e. one

inch equals one and a half feet). (This calculation is only applicable to trees in the Coastal Zone)

If Yes, provide the following information.

a. Has an Arborist Report, prepared in compliance with the Content Requirements for Arborists Reports, beensubmitted? Yes No (If No, please consult with the Planning Division.)

b. Has all other required documentation per the Submittal Requirements for Tree Permits & Authorizations beensubmitted? Yes No Unsure

c. Number of prior protected trees removed from the parcel for reasonable access to or use of property:

No. of oaks: No. of sycamores: No. of other protected trees: Unknown

d. Number of prior protected trees removed from the parcel for agriculture within the last 12 months?

No. of trees: Unknown

e. Provide the following information about any potentially impacted protected trees. Complete one row for eachtree or stand of trees of the same species, heritage status, action and general location.32

ID#

No. of Trees Tree Species

Heritage (90+ inches

girth*)

Action (remove, alter,

encroach) Tree Location

(include reference to a fixed landmark)

Ex. 5 Oak No Remove Back of lot; near SE corner of proposed building.

32 See Appendix T1 , Table 1 for a list of native tree types which could be planted in the Coastal Zone.

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ID#

No. of Trees Tree Species

Heritage (90+ inches

girth*)

Action (remove, alter,

encroach) Tree Location

(include reference to a fixed landmark)

Ex.

1

2

3

4

*Girth is the circumference of the trunk, generally measured at 4.5 feet above the ground. (This position may varydepending upon where the waist of the tree is—the narrowest trunk point is typically the goal—and many other factors.) If there are multiple trunks, measure each and add their measurements together; for heritage trees only the two largest trunks are measured.

f. Have any of the above actions (removal, alteration, encroachment) already occurred?

Yes No If Yes, explain (include tree or tree stand ID#):

Date work was performed:

g. Reason for the above request (indicate if more than one reason, e.g., one oak tree (ID# 1) is hazardous perArborist Report and 4 oak trees (ID# 2-4) need to be removed to construct building):

h. Will any tree species be added to the site to screen or conceal the wireless communication facility?

Yes No

If yes, please list and describe in the table below the quantity, species, and planting size of the trees proposed

to be added to the site.33

33 For planting trees in the Coastal Zone, see CZO, Appendix T1, Table 1, “Native Trees”.

5

5 Oak No Remove Back of lot; near SE corner of proposed building.

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No. of Trees Tree Species Height Irrigation

(yes/no) Tree Location

(include reference to a fixed landmark)

5 Washingtonia filifera

(California Fan Palm)

20 feet Yes Back of lot; near SE corner of proposed building.

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Summary of Documents Required with a Discretionary Entitlement Application for Wireless Communication Facilities

Summary of Doucments Required (11/28/2017) 1 of 2

The following items should accompany your application upon submittal. When applicable please consult the pertinent sections of the Questionnaire (Section III of Application Packet), the Non-Coastal Zoning Ordinance (NCZO) Section 8107-45, and the Coastal Zoning Ordinance (CZO) Section 8175-5.20 to determine if the items are required for your application.

SUBMIT WITH EVERY APPLICATION No. of Copies

Site Plan (confirm number of copies with Discretionary Permit Coordinator) 20 or_______

Questionnaire completed (confirm number of copies with Discretionary Permit Coordinator) 15 or ______

Certification Statement of Hazardous Waste/Substance Site 1

Fee Reimbursement Agreement 1

Lease Agreement, Power of Attorney, or Owner Authorization document 1

Property Owner Authorization and FCC Registration Number/Radio Spectrum Lease Agreement 1

Radio Frequency Emissions Report (See NCZO Sec. 8107-45.3(e), or CZO Sec.8175-5.20.10(d)) 1

Visual Impact Analysis (See Sec. IIC. of Application Checklist, NCZO Sec. 8107-45.3(c), or CZO Sec.8175-5.20.10(d)) 3

SUBMIT WHEN APPLICABLE No. of Copies

Archaeological, historical, and/or paleontological resource survey report 1

Documentation of existence of land use prior to 1985 1

Drainage Study 4

Geology Report 3

Noise Study (see NCZO Sec. 8107-45.3(j), or CZO Sec.8175-5.20.10(g)) 1

Preliminary Title Report 2

Propagation Diagrams (See Sec. IIC. of Application Checklist, NCZO Sec. 8107-45.3(b), or CZO Sec.8175-5.20.10(i)) 3

2488 www.vcrma.org/divisions/planning

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Summary of Documents Required with a Discretionary Entitlement Application for Wireless Communication Facilities

Summary of Doucments Required (11/28/2017) 2 of 2

Restrictive Covenant 1

Soils Report (for new construction/grading)) 3

Stormwater Quality Impact Mitigation Plan (SQUIMP) Worksheet 2

Alternative Sites Analysis (See Sec. IIIC. of Application Questionnaire, NCZO Sec. 8107-45.3(f), or CZO Sec.8175-5.20.10(j)) 1

Initial Study Biological Assessment (See Sec. I.B of Application Introduction) 1

Landscape Plan (see NCZO Sec. 8107-45.3(h), or CZO Sec.8175-5.20.10(k)) 1

Maintenance and Monitoring Plan (see NCZO Sec. 8107-45.3(i), or CZO Sec.8175-5.20.10(f)) 1

Hazardous Material Inventory (see NCZO Sec. 8107-45.3(k), or CZO Sec.8175-5.20.10(h)) 1

2488 www.vcrma.org/divisions/planning

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Check all that apply:Site Plan Adjustment/Permit Adjustment Ordinance AmendmentTree Permit Review VarianceSubdivision Application (PM/TT) Major/Minor Modification General Plan Amendment/Zone Change Land Conservation Act (LCA) Contract Parcel Map Waiver (LLA, Merger, LLS, LES, CS) Conditional Certificate of Compliance Conditional Use Permit Planned Development PermitChange of Use Other:

PROJECT NO.

I, , the undersigned, hereby authorize the County of Ventura to process the above referenced permit request in accordance with the Ventura County Ordinance Code. I am depositing $ to pay for County staff review, coordination and processing costs related to my permit request based on actual staff time expended. In making this deposit, I acknowledge and understand that the deposit may only cover a portion of the total processing costs. Actual costs for staff time are based on hourly rates, which I understand are in the most current fee schedules of each county agency. I also understand that these costs apply even if the application is withdrawn or not approved.

I understand and agree to the following terms and conditions of this Reimbursement Agreement:

1. Staff time from some County of Ventura departments and agencies spent processing my request will be billedagainst the available deposit. “Staff time” includes, but is not limited to, time spent reviewing application materials, site visits, responding by phone or correspondence to inquiries from the applicant,the applicant’s representatives, neighbors, interested parties, attendance and participation atmeetings and public hearings, and preparation of staff reports and other correspondence.

2. If processing costs exceed the available deposit, I will receive periodic invoices payable upon receipt.

3. If the final cost is less than the available deposit fee, the unused portion of the available deposit, includingretention, will be refunded to me.

4. If the final cost is more than the available deposit fee, I agree to pay the difference according to the termsset by the County.

5. If I fail to pay any invoices within 30 days of the billing, the County may either stop processing my permitapplication, or after conducting a hearing, deny my permit request altogether. If I fail to pay any invoices aftermy application is granted, I understand that my permit is subject to revocation. Any work on any subsequentor concurrent permit applications will cease until all unpaid fees are paid in full.

6. Fees are due and payable within 30 days of billing. Invoices unpaid after thirty (30) days will incur a 2% late fee,compounded monthly.

Discretionary Project Reimbursement Agreement County of Ventura • Resource Management Agency and Public Works Agency 800 South Victoria Avenue, Ventura, CA 93009 • www.vcrma.org/divisions/planning

Please initial to show you have read and understand condition 2.

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7. If an Initial Study Biological Assessment (ISBA) report is submitted as part of my application, the County ofVentura may need to refer my ISBA report to a County-contracted biological consultant for review. Should thisreview occur, I will pay a separate fee for the cost of the consultant review. This fee may vary depending on thesize of development footprint and the complexity of the biological resources on the property. Selection of thebiological consultant for this work shall be at the sole discretion of the Planning Director. This fee is not relatedto the above deposit fee and shall be paid within 10 days of written notice that the County has been billed bythe biological consultant.

8. The County of Ventura may refer my application to the South Central Coastal Information Center (SCIC), CSUFullerton, to determine whether an Initial Study (Environmental Analysis) addressing cultural resources willneed to be conducted by a cultural resources consultant. Should this referral occur, I will pay a separate flat feeat the currently established rate (not to exceed $100.00). If further study by a cultural resources consultant isrequired, I will be responsible for any additional costs above the established fee, and I must select the consultant from among those approved by the County of Ventura. All fees shall be paid within 10 days of written noticethat the County has been billed by the SCIC or by the cultural resources consultant.

9. I agree to pay the County of Ventura the cost of placing a legal advertisement (if one is required) in a newspaperof general circulation as required by state law and local ordinance.

10. Upon project approval, if any, I agree to pay the established County Clerk Recorder Environmental Documentfiling fees.

11. I may, in writing, request a further breakdown or itemization of invoices, but such a request is independent ofthe payment obligation and time frames.

12. I agree to pay all costs related to permit condition compliance as specified in any conditions of approval for mypermit/entitlement.

13. FISH AND WILDLIFE REVIEW FEES for discretionary permits and legislative amendments: I further understandthat the County, or the State Office of Planning and Research, may refer my application and/or any applicableenvironmental document for my project to the California Department of Fish and Wildlife for review andcomment in accordance with the provisions of the California Environmental Quality Act. Should this referraloccur, I understand that I must pay all fees as required by Section 711.4 of the Fish and Wildlife Code ($2,210.00for Negative Declarations/Mitigated Negative Declarations or $3,069.75 for Environmental Impact Reports, plusany County Clerk fees as of January 1, 2015). Should these fees be required, I agree to remit a cashier’s check ormoney order in the required amount, payable to the Ventura County Clerk, to the Planning Division prior to anylegal notifications regarding public hearings before the decision making body on my application.

Name of Property Owner or Corporate Principal (please print):

Driver’s License Number: Phone Number:

Name of Company or Corporation (if applicable):

Mailing Address of the Property Owner or Corporation/Company:

Signature:* Date:

*ATTENTION — The property owner (or Corporate principal) will be held responsible for all charges.

Discretionary Project Reimbursement Agreement; May 2016

If a Corporation, please attach a list of the names and titles of Corporate officers authorized to act on behalf of the Corporation

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Certification Statement of Hazardous Waste or Substance Site

County of Ventura • Resources Management Agency • Planning Division 800 S. Victoria Ave, Ventura, Ca. 93009 • 805 654-2488 • www.vcrma.org/divisions/planning

PERMIT NO.

A.P.N.

Pursuant to the requirements of Section 63962.5 of the California Government Code, I certify that the project

site for the above entitlement is not located on the State list of identified hazardous waste/or hazardous

substance sites. I have reviewed the State Water Resources Control Board Geotracker website1 and

determined that the project site for the above entitlement is not located on the State list of identified

hazardous waste or hazardous substance sites.

Applicant or Representative

(Print)

Applicant or Representative Date

(Sign)

1 http://geotracker.waterboards.ca.gov/